UC-NRLF 


B   M    MES   M3T 


LEPROSY 


REPORT  OR  THE  PRESIDENT 

*  OF  THE 

BOARD  OF  HEALTH 

/;^^0  THE 

Legislative  Assembly 

OF  1886. 


HONOLULU,  H.  I. 

DAir.T    BULLETI       oTEAM    PRINTING    OFFICE. 

'      '1886. 


REIGN  OF  HIS  MAJESTY  KALAKAUA,  13th  YEAR. 


REPORT  OF  THE  PRESIDENT 


OF  THE 


BOARD  OF  HEALTH 


TO  THE 


Legislative  Assembly 

OF  1886, 

ON  LEPROSY. 


HONOLULU,  H.  1. 

DAILY    BULLETIN    STEAM   PRINTING    OFFICE. 
188G. 


REPORT  OF  THE  PRESIDENT 

OF  TTTE 

BOARD  OF  HEALTH 

TO  THE 

Legislative  Assembly  of 

ON  LEPROSY. 


Office  of  Boakd  of  Health, 

HoxoLULF,  April  :>()tlL  18S(). 

NoUes  and  Eepresentatives: 

When,  twenty-one  yeai-s  ago,  (January  3,  1865,)  tlie 
Legislature  of  this  Kingdom  enacted  the  law  '*to  pre- 
yent  the  spread  of  Leprosy,''  it  was  provided  that  the 
Board  of  Health, — the  Dejjartment  authorized  to  carry 
out  its  provisions, —should  report  to  the  Legislature  at 
each  of  its  regular  sessions,  the  expenditures  in  detail, 
together  ivith  such  information  regarding  the  disease  of  leprosy^ 
as  well  as  the  public  health  generally,  as  it  may  deem  of 
interest  to  tlie  pMie. 

During  the  twenty  years  and  oyer  that  haye  elapsed 
since  the  ])assage  of  the  Act  referred  to,  and  the  com- 
pilation of  the  now  famous  Report  of  the  College  of 
Physicians  of  England  on  leprosy,  obtained  at  the  in- 
stance of  Her  Britannic  Majesty's  Goyernment,  the  stu- 
dy of  the  disease,  that  has  prevailed,  and  to  a  great  ex- 
tent, still  prevails  so  virulently  in  this  Khigdom,  has 
been  pressed  with  unremitting  zeal  aud  perseverance  in 
nearly  every  country  by  men  of  medical  and  scientific 
attainments.  By  degrees,  through  unceasing  and 
Avatchful  labor,  by  comparison   of   inforjnation  and  in- 

"m185908 


terchaiige  of  experiences,  experiments  and  thought, 
and  to  no  small  extent  perhaps,  also,  l)y  uplifting  the 
heavy  curtains  of  past  centuries  and  unrolling  the  sci-oUs 
penned  by  those  familiar  with  this  disease,  thousands 
of  years  before  the  birth  of  the  Saviour  of  Man,  and  by 
the  material  aid  of  practical  common  sense  joining  its 
forces  to  those  of  medical  science,  the  latter  prone,  alas, 
at  times  to  be  blindly  self-assertive,  dogmatic  and 
tyrannical  as  much  so  to  day  as  in  the  day  of  Hervey, 
Jenner,  and  other  great  pioneers  in  medical  thought 
— the  world  has  learned  much,  and  the  indications  are 
that  knowledge  is  increasing  so  steadiU^  and  favorably 
that  we  are  almost  half  justified  in  hoping  that,  at  the 
end  of  the  next  quarter  of  a  century,  the  time  will 
then  be  not  far  distant  that  a  controlling  power  shall 
be  found  for  that  disease  of  which  one  Atreya,  who 
wrote,  in  India,  probably  more  than  4000  years  ago, 
said  "The  man  who  neglects  the  disease  at  its  commencement 
is  sure  to  die,  for  it  becomes  incurable.'' 

With  these  facts  and  thoughts  present  in  my  mind, 
I  have  deemed  it  a  duty  I  owe,  as  the  President  of  the 
Board  of  Health,  to  the  Hawaiian  nation,  and  in  that 
spirit  of  benevoJence  to  the  sufferer,  be  he  Hawaiian 
or  foreigner,  which  has  been  one  of  the  marked 
features  of  the  Hawaiian  race  and  its  rulers,  and  espe- 
cially so  during  the  present  reign,  to  make  a  more  ex- 
tended Report  to  your  Honorable  Body  than  has  hith- 
erto been  customary.  I  have  done  so  in  the  fervent 
hope,  that  under  the  Divine  Will,  good  will  result  not 
only  to  this  nation  but  to  other  parts  of  the  world  at 
large,  suffering  alike  with  Hawaii. 

I  have  endeavored  to  present  to  you,  in  so  far  as  a 
pressure  of  duties  and  limited  opportunities  permitted, 
the  knowledge  and  information,  in  regard  to  leprosy 
possessed  by  many  other  countries,  compiled  and 
collected  by  the  Governments  of  those  countries  ex- 
pressly for  His  Hawaiian  Majesty's  Government,  at  my 
invitation,  and,  in  some  instances,  bearing  date  as  re- 
cently as  the  present  year.  To  these  governments  the 
Hawaiian  people  should  be  grateful. 


In  this  Report,  taken  in  connection  with  the  Snpple- 
ment,  I  aim  to  lay  before  you  the  history  of  the  disease 
in  these  Islands  so  far  as  it  is  to  be  found  in  the  official 
records  of  the  Board  of  Health  and  other  sources,  and 
60  far  as  my  researches  and  my  experience  as  a  resi- 
dent of  a  quarter  of  a  century  in  the  Kingdom  permit. 
In  the  Appendix  you  will  find  the  results  of  the  la])ors, 
and  the  opinions  and  suggestions  of  the  medical  men 
and  others,  who  are,  or  have  been,  engaged  on  these  Is- 
lands since  the  presentation  of  m}^  last  report,  in  com- 
bating the  disease,  attending  to  the  sick,  amehorating 
their  sad  condition  or  soothing  their  dying  hours. 
I  am  convinced  that  a  careful  study  of  the  material 
presented  to  you  will  not  only  aid  your  deliberations 
on  behalf  of  the  suffering  and  sick  among  the 
Hawaiian  people,  and  encourage  hope  in  your 
breasts  and  theirs,  but  it  will  also  show  you 
that  the  Hawaiian  nation,  acting  through  those  who 
have  been  entrusted,  from  time  to  time,  with  the  ad- 
ministration of  its  affairs  has  done  nobly,,  and  gene- 
rously in  the  front  of  a  great  calamity,  and  has  dared 
more,  and  expended  more  money  in  ^^I'oportion  to 
the  size  and  wealth  of  the  country  in  the  attempted 
suppression  of  this  most  lamentable  malady  than  great- 
er, more  powerful  and  wealthier  countries  have  yet  at- 
tempted. It  will,  I  trust,  tend  to  preserve  in  you  that 
true  kindliness  of  heart,  and  that  spirit  of  compassion 
towards  the  poor  and  suffering,  that  were  the  pride  of 
your  ancestors,  and  which — bloody  and  cruel  though 
they  may  have  been  in  battle-led  them  more  rapidly 
on  the  pathway  of  enlightenment,  civilization  and 
patriotism  than  any  other  race  similarly  constituted  and 
situated  as  was  the  Hawaiian  when  the  foreigner  first 
reached  these  shores. 

A  wise  and  eloquent  writer  has  said;  ''that  no  na- 
tion can  go  forwai-d  that  has  no  past  at  its  back.- '  Ha- 
waii has  both  a  past  and  a  histor}^  in  which  may  not 
only  be  traced  the  germs  and  causes  of  its  progress,  but 
possibly  also  the  source  of  the  disease,   so  far  as  this 


() 

country  is  ooiicoi'iiorl,  which  forms  the  sad  subject  of 
this  Report.  Tlie  Khigdom  of  Hawaii  in  its  political, 
social  and  religious  life  in  the  transition  ''fi'oni  feudal 
anarchy  and  general  lawlessness  to  personal  despotism 
and  strhigent  i-epression,  and  from  that  to  a  constitu- 
tional monarchy ;  from  social  barbarism  to  a  degree  of 
civilization  that  is  unexampled  m  the  histoiy  of  man- 
kind, considermg  the  time  that  has  elapsed ;  from  the 
most  cruel  and  oppressive  idolatry  to  thQ  spontaneous 
repudiation  of  the  idols  and  the  ado})tion  of  Chiistianity'' 
owes  its  initial  movement  on  the  road  of  national  pro- 
gress to  Kamehameha  the  Conqueror.  It  is  true 
as  Fornander  says  :  '"  The  dark  shadoAvs  wdiich 
flit  across  its  pages  are  dark  indeed,  but  the^^  are  no 
darker  than  those  which,  under  even  more  fa^'orabie 
circumstances,  have  stained  the  annals  of  many  a  proud 
nation  that  formerly  stood,  or  now  stands,  in  the  fore- 
most rank  of  civilization.''  That  during  this  extra- 
ordinary political  and  social  revolution  the  shadows 
were  not  darker  is  due  to  the  warrior-king.  There 
would  seem  to  have  been  a  marked  dispensation  of 
Providence  in  the  selection  of  Kamehameha  the  First 
to  direct  the  chain  of  events  during  this  marvelous 
transition  period  which  succeeded  the  union  of  the  is- 
lands imder  one  s])ear  and  sceptre  and  the  coming  of  the 
Avhite  i-ace.  The  Kingdom  had  the  advantage  of  a 
i-uler  of  marked  and  hei'oic  character  as  its  founder;  a 
man  of  vigorous  and  active  intelligent  thought,  endow- 
ed with  a  strength  of  purpose  and  [)ower  which,  had  it 
been  directed  merely  to  personal  aggrandizement  and 
to  sensual  and  sensuous  existence,  would  have  made 
him  a  cruel  and  selfish  tyrant,  and  have  placed  these 
islands  either  in  a  state  of  contimial  insuri-ection,  or  of 
servile  debase-ment  and  degradation,  to  fall  an  eas}^  W^J 
to  the  foreign  conqueror  or  as])iring  adventurer,  as  we 
see  to  day  is  the  condition  of  other  islands  in  the  great 
ocean  that  surrounds  us.  Fortiuiately  he  was  destined 
to  set  an  example  to  his  successors  as  favoring  the 
establishment  and  deAxdopment  of  this  Kingdom  as  an 


Indcpc'iidejit  State.  He  appivciatccK  and  lieivin  may 
hv  found  one  of  the  marked  reasons  of  his  special  sne- 
eess  and  the  proof  of  his  enhghtened  spirit,  the  vahie 
of  recognizing  and  acting  upon  the  proffers  of  friendly 
reciprocation  and  association  Avith  tlie  C.'aucasian  I'ace 
and  of  learning  from  them  the  arts  of  peace  rather  than 
the  ])ractice  of  war.  lie  accepted  then*  teachers  and 
traders  as  his  tutors  ajid  councillors,  and  amity  and  ad- 
vice hegat  knowledge  throughout  the  land.  Hence  it 
is  that  since  he  ascended  the  throne  of  United  Hawaii, 
AVe  have  no  l^loody  record  of  internecine  Avars,  of  strug- 
gles betAveen  race  and  race  :  of  hatred,  open  or  coA-ei't ; 
of  jdots  and  counterplots  hetween  the  luitiA^e  population 
and  the  strangei's ;  l)ut^  on  the  other  hand,  calm  con- 
sultations, friendly  co-operation,  and  active  associations 
intimately  connected  Avith  the  advancement  of  the 
country.  Hence  also,  to-day,  the  HaAvaiian  State 
stands  solid  and  independent  before  the  Avorld,  so  estab- 
lished by  the  wisdom  of  its  native  chiefs,  aided  in  its 
oi-ganization  and  progressiAX^  dcA^elopment  l^y  a  loyal 
and  zealous  white  element  Avho  Iuia'c  l)ecome  heartily 
and  honestly  HaAvaiian  in  disposition,  interest  and  so- 
cial kinship,  and  as  closely  identified  Avith  the  Avelfare 
of  the  land  as  though  it  Avere  the  birthplace  of  them- 
selves and  ancestors,  rathei-  than  a  land  of  adoption. 

The  spirit  of  Kamehameha  and  his  advisers  develop- 
ing and  becoming  enriched  by  ciAilization  and  intelli- 
gence descended  to  his  royal  successors  until,  under 
our  present  Sovereign  Kahikana,  the  second  transition 
era  may  be  said  to  have  arri\'ed,  since,  from  the  King 
downAvards,  the  generations  of  to-day  have  been  edu- 
cated— not  under  the  old  HaAvaiian  system,  but  under 
the  intluence  of  Christian  and  Caucasian  methods  and 
ideas.  The  puny  neglected  islands  of  the  Pacific 
hailed,  scarcely  a  centur}^  ago,  as  mei'cly  a  new  acqui- 
sition for  a  missionary  station,  oi*  a  half-way  inn  for 
sailors,  are  ra])idly  gaining  recognition  as  Avoithy  to  be 
ranked  and  receiAX'd  among  the  most  powerful  and  en- 
lightened Sovereig])  States  r)f  the  world,  as  behig  fniit- 
ful  of  good  deed^  in  prate ^  though  powerlea^  in  war. 


s 

III  this  half-won  struggle  for  advancement,  Hawaii 
has  undergone,  and  is  still  undergoing,  the  stern  trials 
attaching  to  all  rising  nations.  She  has  been  heavily 
handicapped  in  being  stricken  with  the  terrible  and 
deadly  disease  of  leprosy  and  with  other  maladies  that* 
have  carried  off  her  people  l^y  the  hnndreds  of  thou- 
sands. Elsewhere  T  shall  speak  of  the  lives  we  have 
lost  and  the  treasure  we  have  expended  on  account  of 
these  visitations. 

But  why  should  these  Islands  have  been  so  signally  af- 
flicted? There  must  be  a  cause  for  it.  In  these  days 
we  cannot  be  content  with  the  explanation  of  the  mid- 
dle ages  that  it  is  the  wTath  of  God. 

In  view,  then,  of  the  great  and  bcAvildenng  masses  of 
information  gathered  by  medical  men  as  to  the  causes 
of  leprosy,  and  in  view  also  of  the  many  published  er- 
rors in  regard  to  leprosy  in  this  Kingdom,  let  us  search 
for  a  sensible  cause  practically,  and  not  as  professionals 
pledged  to  individual  schools  of  thought  or  line  of  ex- 
})eriments.  Let  us  do  it  in  a  fiiendly  attempt  to  aid 
science  and  not  to  baffle  it  or  ourselves,  and  not  in  an 
assertive  but  in  an  enquiring  mood,  having  for  our 
main  object  the  elucidation  of  facts  and  the  alleviation 
of  the  misery  of  our  suffering  countrymen. 

Whoever  will  studiously  peruse  the  very  numerous 
medical  statements  wdiich  accompany  this  report,  will 
observe  that  each  of  the  piopositions  I  am  about  to 
place  before  you  can  be  ansAvered  as  readily  in  the  af- 
flrmative  as  in  the  negative,  and  with  probably  an  equal 
array  of  argument  on  either  side.  Let  us  make  these 
propositions  then,  thus: 

It  is  impossil)le  to  attach  to  this  Hawaiian  race  and  to 
these  Islands  any  distinctive  feature  as  a  character  or 
cause  of  the  disease. 

It  will  not  do  to  say  that  it  is  owing  to  an  admixture 
of  foreign  races  predis])osed  to  the  disease,  or  to  ui- 
breeding  producing  scrofulous  races,  or  that  the  race 
is  iu  itself  predisposed  to  scrofula,  malaria  and  many 
other  assistant  diseases. 


9 

It  will  not  do  to  say  that  it  proceeds  from  climate, 
from  the  diet  of  the  country  or  from  want  of  cleanliness. 

It  will  not  do  to  attribute  it  to  any  of  these  causes, 
solely  or  conjunctively,  for  the  unfortunately  baffled 
medical  world  i-epeatedly  points  out  to  us  that  all  these 
conditions  exist  m  non-leprous  countries  and  races.  I 
will,  however,  presently  review  all  these  conditions  as 
they  are  found  amongst  us,  and  see  whether  or  not  they 
can  be  made  actually  applicable  to  us  wholly  or  in  a 
degree. 

A])out  the  great  hold  that  leprosy  has  taken  upon 
this  nation,  there  is  no  doubt;  but  as  to  when  it  first 
began  its  ravages  here  there  is  very  grave  doubt,  and 
in  the  ascei'taining  of  the  era  of  misfortune  may  be 
found  a  solution  of  one  portion  of  the  perplexing  prob- 
lem. Although  it  has  been  stated  by  our  best  medical 
observers  that  the  disease  is  but  a  recent  comer  among 
us,  and  dating  back  not  more  than  40  or  50  years  ago, 
I  am  strongly  disposed  to  join  issue  with  them. 

THE    IXTRODUCTIOX    OF    THE    DISEASE. 

It  has  been  asserted  l)y  the  early  authorities  that 
leprosy  was  introduced  by  a  Chinaman,  and  conse- 
quently was  called  the  3Iai  PaJce^  or  Chinese  sickness,  as 
native  Hawaiian s  could  find  no  better  name  for  the 
disease  in  their  vocabulary.  I  do  not  believe  it  was 
introduced  by  a  Chinaman,  any  more  than  I  believe  it 
was  imported  from  China  by  the  warrior  chief  Keawe 
Kaiana-a-Ahuula  when  he  made  his  voyage  with  Cap- 
tain Meares  in  1787.  I  might,  en  passant,  enquire  how 
it  is  that  if  one  Chinanian  caused  such  an  alarming 
spread  of  the  disease  thirty  or  forty  years  ago,  there 
are  now,  comparatively  speaking,  so  very  few  cases  of 
leprosy  among  the  seventeen  or  eighteen  thousand 
Chinamen  on  these  islands,  and  no  recorded  cases,  that 
I  am  aware  of,  of  an  imported  Chinese  leper  since  the 
enactment  of  the  anti-leprosy  law.  Again,  if  the  disease 
had  been  inti'oduced  by  the  Chinese,  and  propagated 
by  them  in  propoition  to  their  intimate  connection  and 
2 


10 

association  with  tho  females,  especially  young  children, 
of  the  native  race,  I  should  expect  to  find  a  nuich  larger 
proportion  of  females  than  males  affected  with  this 
loathsome  malady,  and  yet  we  all  know  that  the  con- 
trary is  the  fact,  in  spite  of  the  census  of  1884  giving 
only  18,220  females  over  15  years  of  age  to  17,000 
male  Chinese  of  all  ages. 

To  those,  who  are  intimately  acquainted  with  the  Ha- 
waiian language,  the  mere  fact  that  thei-e  is  not  a  dis- 
tinctive word  in  the  language  argues  nothing,  inasmuch 
as  the  idiom  is  remarkably  deficient  in  medical  nomen- 
clature,  consequent  upon  the  absenoe  of  any  regular 
study  of  the  human  system  or  ailments.  The  Hawaiians 
possess  generic  words  for  the  pains  or  sensations  attach- 
ing to  the  several  classes  of  sickness  to  which  they  are 
most  prone,  such  as:  Mai  tvela^  hot  sickness;  mat 
anuu.  cold  sickness ;  mai  puupim^  lumpy  sickness ; 
mai  ulalii,  sickness  of  small  red  spots  (measles),  and 
so  on.  I  believe  that  there  is  enough  of  assurance  in 
the  general  opinions  of  mtelligent  Hawaiians  that  the 
disease  has  existed  here  for  a  much  longer  jjeriod  than 
usually  accredited.  Old  natives  speak  of  a  disease  in  the 
past,  attended  with  swellings,  disfigurations,  insensibility 
and  nlcerations,  and  wdiich  diseases  correspond  with 
what  mcHlical  science  calls  Ehphantiasls  Arahurn^  and  not 
true  leprosy ;  but  thei'e  is,  nevertheless,  some  ground 
for  the  presumption  that  the  Elephantiasis  Grcecorum^  or 
true  leprosy,  existed  since  ancient  times.  However,  hi 
the  absence  of  fact  this  is  only  siu-mise.  But  in  this 
connection  an  interesting  extract  from  the  diary  of 
Kev.  C.  8.  Stewart,  1823,  will  be  found  hi  the  report 
of  Dr.  Moui'itz,  on  page  LXXIY,  Appendix  K.  On  P. 
XXA  Til  of  Appendix  E,  a  well  defined  case  of  leprosy 
in  1845  is  mentioned,  and  cases  might  be  given  dating 
back  into  the  l^hirties.  I  am  inclined  to  think  that 
the  disease  escaped  the  notice  of  the  early  missionary 
nK^lieal  writers  owing  to  the  fact  that  their  want  of 
knowledge  of  its  true  s}'mptoms  and  correct  diagnosis 
led  them  to  place  it  within  the   definitions  of  venereal 


11 

and  scrofulous  ailments.  Their  writings  and  opinions 
are,  however,  to  a  certain  extent  vahiahle,  and  it  is 
only  fair  that  we  should  consult  them  in  our  desire  to 
learn  all  Ave  can  in  regard  to  the  various  causes  as- 
signed luid  the  circumstances  attendant  upon  the  upris- 
ing of  this  disease  hi  its  peculiai-  virulence.  Let  us 
then  turn  to  these,  the  earhest  of  our  foreign  ohservers, 
and  see  what  they  had  to  say  in  regard  to  the  inhahi- 
tants  of  these  islands  within  ten  and  twenty  years  of 
the  date  of  the  landing  of  the  first  American  mission- 
aries in  TS20.  They  write  fi'cely  a])out  the  diseases 
and  condition  of  t\n^^  i)eople,  of  their-  food,  their  cus- 
toms and  their  morals  in  the  ei-a  hefore  which,  modern 
writers  would  have  us  heiieve,  leprosy  Ix^gan  its  ravages 
among  our  peojjle. 

THE    XATl  RAL    PHEXOMP:XA    OF    THE    TSLAXDS. 

But  first,  as  regards  climate,  which  some  writers 
think  is  a  potent  factor  in  the  disease,  I  cannot  do  bet- 
ter than  quote  from  Dr.  Alonzo  Chapin's  description 
repubhshed  from  the  ''American  Journal  of  Medical 
Sciences  "  in  the  ''  Hawaiian  Spectator,"  of  July,  1838. 
Dr.  Chapin  says:  ''Situated  in  the  very  midst  of  the 
vast  Pacific,  without  au}^  extensive  inland  causes  to  af- 
fect the  temperature,  and  remote  from  the  cold  chilling 
winds  of  the  temperate  and  frigid  zones,  the  Sandwich 
Islands  possess  a  remarkable  evenness  in  the  degree 
of  atmos])hei'ic  temperature.  Cool  Ijreezi^s,  by  day 
from  the  sea,  and  by  night  from  the  mountains,  serve  to 
mitigate  the  ])urning  heat  produced  by  a  vertical  sun, 
and  to  render  the  climate  pleasant.  The  thermometer 
varies  but  little  from  day  to  da}^,  and  even  from  month 
to  month ;  and  what  is  pai'ticularly  to  be  remarked,  all 
portions  of  the  ishnids,  along  the  shores,  are  alike  in 
this  respect.  Districts  most  parched  by  heat  and 
drought  do  not  differ  essentially  in  temperature  from 
those  sections  where  almost  daily  showers  and  perpetual 
trade  winds  prevail.  As  we  recede,  however,  from  the 
low  lands  along  the  sea  and  ascend  the  mountains,  a 


12 

change  is  immediately  perceived,  and  along  their  ex- 
tended sides  we  may  procure  almost  any  degree  of  tem- 
perature. The  greatest  heat  marked  by  the  thermom- 
eter at  Honolulu  was  88  ^  ,  lowest   59  ^  ,  and   range 

In  dealing  with  the  telluric  agencies  and  physical 
conformations  of  the  islands  I  prefer  to  agahi  quote 
from  the  same  distinguished  medical  authoi-ity  who  says  : 
"The  interior  of  each  island  is  uniformly  elevated,  and 
among  them  are  found  mountains  of  the  first  order  of 
elevation.  Those  on  Hawaii  rise  to  the  height  of  about 
14,000  feet  and  have  snow  on  their  summits  a  great 
part  of  the  year.  The  whole  group  are  of  volcanic  ori- 
gin. Xumerous  extinct  craters  of  different  periods  and 
dimensions  are  scattered  over  the  surface,  and  two 
large  volcanoes  are  still  in  action,  affording  immense 
currents  of  liquid  lava.  The  shores  of  the  islands  are 
much  diversified,  and  furrowed  with  frequent  ravines, 
some  of  great  depth,  which  furnish  courses  for  the  im- 
petuous mountain  streams.  Plains  of  different  dimen- 
sions, varying  from  a  few  rods  to  many  miles  in  extent, 
are  fi'equent.  More  commonly,  however,  the  moun- 
tains extend  with  a  gradual  slope  entirely  to  the  beach, 
and  here  and  there  present  bold  and  black  lofty  preci- 
pices to  the  dashing  of  the  wave.  The  sides  of  the 
mountains,  if  we  except  the  loftiest,  are  verdant  entire- 
ly to  their  summits,  and  present  immense  tracts  of  ex- 
ceedingly fertile  soil.  The  leeward  shores  have  gene- 
rally an  arid  and  even  sterile  aspect,  owing  to  the  infre- 
quency  of  rain.  Vegetation  is  there  promoted  mostly 
from  h-rigation  from  the  streams,  and  it  is  only  the 
tracts  immediately  contiguous  to  these  which  possess 
much  verdure,  or  will  admit  of  cultivation.  The  con- 
densation of  the  vapor,  from  the  damp  trades  in  their 
passage  over  the  mountains,  produces  continual  rains 
on  their  summits,  which,  extending  backwards  towards 
the  sea,  keep  the  earth  wet  much  of  the  time,  and  give 
rise  to  a  luxuriant  growth  of  vegetation.  Hence  the 
windward  sides  of  all  the  islands  are,   unlike  their  lee- 


13 

ward  shores,  extremely  fruitful  aud  productive.  "^  *  * 
The  streams  originate  from  spiings  and  rahis  on  the 
summits  of  the  mountains,  pour  down  their  sides  with 
great  impetuosity  and  after  a  few  meanderings  are 
turned  aside  from  their  course  to  irrigate  the  lands  and 
replenish  the  fish  ponds,  or  are  discharged  directly  into 
the  sea ;  and  I  know^  of  no  hody  of  water  emitting  suf- 
ficient miasma  to  create  sickness  along  its  horders.  I 
have  occasionally  met  with  stagnant  ponds,  which  emit 
a  foul  and  offensive  odor,  and  could  in  no  w^ay  satisfy 
myself  of  the  reason  for  the  exemption  of  tlie  inhahi- 
tants  along  their  horders  from  fevers,  hut  hy  supposing 
the  effluvia  to  be  diluted  and  i-endered  inert  hj  the  con- 
tinual currents  of  winds.  Small  marshes  abound  but 
are  fed  by  springs,  and  the  pure  mountain  streams,  and 
are  thus  prevented  becoming  noxious.  They  speedily 
dry  up  during  a  few  weeks  absence  of  rain ;  and  the 
rivers  also  disappear  unless  kept  alive  by  frequent 
showers,  and  the  small  pools,  which  remain  at  such 
times  and  which  abound  after  every  rainy  season,  do 
not  become  sufficiently  putrid  to  exhale  ix.  fever-generating 
miasma.  If  any  one  variety  of  soil  has  a  specific  power 
to  produce  malaria  it  does  not  appear  to  exist  at  those 
islands.  ,  The  upland  soil  is  there  formed  of  decom- 
posed lava,  the  lowland  plains  along  the  sea  are  consti- 
tuted of  a  mixture  of  alluvion  washed  from  the  moun- 
tains, and  decomposed  coral.  Its  immunity  from  nox- 
ious exhalations  is  the  same,  whether  parched  with 
drought,  or  n.ierely  moist,  as  when  the  evapoi*ation  is 
most  abundant  after  the  rains." 

The  native  food  next  claims  our  attention.  The 
staple  article  of  diet  as  descril^ed  by  Chapin  was  poi, 
''The  Arum  Fscukntum,  which  is  more  generally  eaten 
l)y  the  inhabitants  than  any  other  vegetafele,  grows  like 
the  Armn  triphjjlhnn,  in  wet  or  damp  situations  only,  and 
Avhen  uncooked,  is,  like  that,  exceedingly  styptic  and  ac- 
rimonious. These  qualities  are  destroyed  by  heat.  The 
natives  prepare  it  for.  use  by  cooking  it  thoroughly, 
pounding  it  to  a  pulp,  and  adding  water  sufficient  to 


u 

make  a  thick  paste,  In  which  state  it  is  called ^;oz;  and  thus 
prepared,  it  is  eaten  with  one  or  two  lingers,  accord- 
ing to  its  consistency.  As  an  article  of  diet  it  is  simple 
and  Jiutritions ;  and  after  the  fermentative  process  has 
commenced  it  is  preferred  by  the  people." 

The  sweet  potato,  the  pala,  a  fern  root,  the  tops  of 
the  pulu  fern,  the  l)i"ead  fruit,  the  cocoanut,  the  candle 
nut,  the  banana,  many  varieties  of  sea  weed,  along  with 
a  great  variety  of  fish  and  Crustacea,  eaten  raw,  and  the 
meat  of  the  hog  and  dog,  baked  in  the  earth,  consti- 
tuted the  chief  articles  of  ancient  Hawaiian  diet. 

EAllLY   DISEASES    OF    THE    IIAWATIAXS. 

Having  thus  touched  upon  three  ' '  influential  factors ' ' 
let  mt?  pass  on  to  what  these  writei-s  say  in  regard  to 
the  diseases  which,  according  to  their  information  and 
opinions,  afflicted  the  Hawaiians  in  those  days.  Dr. 
Chapin  says:  ''The  equableness  of  the  climate,  and 
the  simplicity  of  the  natives  in  their  regimen  and  most 
of  their  habits  of  life,  are,  compared  with  civilked countries, 
feuch  that  the  variety  of  their  diseases  is  neither  numerous 
nor  complex.  Their  remoteness  from  other  lands  is  so 
great  that  but  few  contagious  diseases  are  imported 
among  them.  ^  ^  ^  Xhe  diseases  most  connnon 
within  my  circle  of  ol^servation,  were  fevers,  ophthalmia, 
catarrhs  and  asthma,  rheumatism,  venereal  diseases, 
diarrhoea,  dysentery,  cutaneous  diseases,  scrofula, 
dropsy,  etc.,  and  they  occurred  in  frequency  and  in 
about  the  order  in  wdiich  I  have  mentioned  them.  Dis- 
eases sometimes  occur  epidemically,  as  was  the  case 
wdth  catarrh  repeatedly,  and  croup  once  during  my  resi- 
dence at  the  islands.  Many  other  diseases,  not  speci- 
fied, were  often  met  with.  Fevers. — Though  this  is 
the  most  frequent  and  numerous  class  of  diseases  among 
the  native  population,  they  are  by  no  means  the  most 
malignant  and  fatal.  They  occur  in  almost  every  form, 
but  when  idiopathic  are  usually  remittent.  They  are, 
however,  most  frequently  symptomatic  of  other  diseases. 
The  excitable  state  of  the  system,   which  predisi:)oses 


15 

so  strongly  to  febrile  attaeks  is  not  couiinon  to  these 
islands.  The  continued  and  oppressive  heat  is  there  not  stif- 
ficient  of  itself  to  produce  it^  and  the  universal  custom  of 
the  [)eoi)le,  to  repose  during  the  hottest  ])art  of  the  day, 
aids  in  counteracting  other  unfavoral^le  influences. 
The  siniplicit}^,  too,  of  their  diet  and  habits  of  life  is  not 
calculated  to  promote  a  state  of  excitability.  Their 
food  is  mostly  vegetable,  Avith  but  a  scanty  and  irregu- 
lar supply  of  meat.  Until  of  late  they  have  made  use 
of  none  of  the  stimulating  condiments  so  profusely  eni- 
plo}'ed  in  civilized  countries,  their  only  drink  is  water. 
In  their  movements  the  natives  are  extremely  moderate. 
They  walk  with  a  slow  step,  rest  long,  and  often  when 
tired,  and  placing  no  value  on  time,  they  do  everything 
leisurely  and  to  suit  their  convenience.  "^  ^  With  so 
entire  an  exemption  from  the  existence  of  miasmata, 
there  is  also  an  entire  exemption  from  those  affections 
induced  by  it.  Malignant  ])iliou8  fevers  do  not  occur, 
■^  '^''  ^  derangements  of  the  liver  and  biliary  or- 
gans do  not  prevail,  neither  are  the  stomach  and  intestinal 
canal,  and  other  organs  of  the  al)dominal  viscera  sub- 
ject to  the  numerous  and  complicated  affections  so  com- 
mon in  every  miasmatic  region." 

Dr.  Chapin  then  discusses,  and  the  point  may  have  an 
important  bearing  upon  the  disease  I  am  considering, 
''some  particulars  of  a  cause  (colds)  which  operates 
more  extensively  than  any  other  morbific  agent,  and 
produces  pi'obably  more  than  one  half  of  all  the  diseases 
which  exist,  and  more  than  three-quarters  of  all  the  idio- 
pathic fevers  on  the  islands."  ''The  habitations  of  the 
natives,"  says  the  Doctor,  ' '  are  for  the  most  part  consid- 
erably scattered,  l)ut  in  a  few  instances  crowded  to- 
gether in  such  numbers  as  to  exhibit  the  dense  appear- 
ance of  large  towns  and  villages.  There  is,  however, 
throughout  an  entii'e  exemption  from  those  pestiferous 
exhahitions  which  so  extensively  poison  the  atmosphere 
of  populous  places  in  hot  climates.  All  animal  and  veg- 
etable substances  throwii  away  by  the  people,  or  cast 
up  by  the  sea,  are  quickly  devoured  by  the  number  of 


IG 

starving  dogs  and  swine,  so  that  no  detriment  is  expe- 
rienced from  their  pntref action,"  but  "  the  dwellings  of 
the  native  population  are  merely  slender  frames  of  posts 
and  poles  tied  together  with  strings  and  covei'cd  only 
with  thatch.  They  are  generally  small,  often  so  low 
as  not  to  admit  of  standing  erect  within,  and  in  their 
best  condition  serve  as  an  imperfect  protection  from  the 
wmd  and  rain,  and  the  excessive  heat  of  a  vertical  sun. 
Every  atmospheric  change  is  quickly  felt.  Cold  and 
dampness  easily  penetrate,  and  no  sooner  exist  without 
than  they  are  felt  within.  Add  to  this  their  leaky  con- 
dition, the  almost  naked  state  of  the  inhabitants,  their 
common  i)ractice  of  sleeping  at  night  on  the  bare  earth, 
outside  of  their  houses,  and  their  habit  of  continuing 
long  in  the  water  and  exposing  their  bare  bodies  to 
strong  currents  of  wind,  when  overcome  Avith  heat  and 
perspiration,  and  it  will  not  be  surprising  that  diseases 
incident  to  such  causes  should  abound.  Fevers,  in- 
duced thereby,  are  numerous." 

COXSTKUCTION    OF    NATIVE    HOUSES. 

Xow  let  me  turn  to  the  '•^Answ^ers  to  Questions,"  pro- 
posed by  the  late  Eobert  Criehton  Wyllie,  the  faithful 
Minister  of  Hawaiian  Kings,  and  addressed  to  all  the 
missionaries  on  the  Hawaiian  Islands,  May,  1846,"  and 
presented  to  the  Hawaiian  Legislature  of  1848,  and  see 
what  these  gentlemen  said  in  regard  to  the  same  sub- 
ject. My  reason  for  quoting  so  largely  from  these 
writers  of  forty  years  ago  will  be  apparent  later  on. 

Kev.  T.  Coan  says:  ^'jSTative  houses  are  usually  too 
small,  too  low,  too  dark,  not  well  ventilated,  too  filthy 
and  too  perishable  in  their  materials  and  construction." 
Eev.  J.  S.  Green  says:  '^The  native  houses  are  cer- 
tainly defective,  exceedingly  so.  Most  of  them  are 
without  partitions.  "'•  *  ^  Still  nearly  all  could 
]nake  improvements  in  their  style  of  l)uilding  did  they 
i-ealize  the  importance  to  their  physical  and  moral  health 
of  having  comfortable  dwellings."  Rev.  E.  W.  Clark 
says:   ''The  houses  gene t-ally  are  grass  huts,  many   of 


Pf 


them  miserable.  Some  have  permanent  partitions,  but 
not  the  majorit3^  Less  improvements  have  been  made 
in  houses  and  in  dress  and  furniture.  ^  *  -h-  ^^_ 
tives  accustomed  so  long  to  a  mere  shelter,  do  not  feel 
the  inconvenience  of  their  houses."  Kev.  R.  Arm- 
strong says:  ''The  houses  ai'e  generally  too  small, 
without  ventilation,  floors,  windows,  or  partitions,  and 
extremely  unhealthy.  Many  are  very  damp  from  the 
ground  as  well  as  from  the  rain.  Rev.  B.  W.  Parker 
says:  ''The  native  houses  are  almost  invariably  small, 
poor  and  uncleanly."  Rev.  A.  Bishop  says:  ''The 
houses  of  the  common  people  are  defective  in  almost 
everything  which  constitutes  civilization."  Rev.  J.  S. 
Emerson  says:  "The  native  grass  houses  when  well 
built,  are  probably  more  healthy  than  any  others,  if  they 
are  not  suffei*ed  to  be  damp  by  having  no  flooor.  The 
convenience  of  wdndows  would  be  great  but  expensive. 
Floors  would  greatly  induce  to  health,  partitions  would 
aid  much  in  advancing  moral  purity ;  but  neither  are 
much  sought  by  the  people  at  present."  The  Rev. 
Mr.  Green  says:  "The  method  of  living  in  small 
houses,  having  no  partitions,  and  crowded  with  men, 
w^omen  and  children  is  exceedingly  unfavorable  to  the 
formation  and  strengthening  of  virtuous  habits,  but  ex- 
ceedingly favorable  to  the  vicious  propensities."  Mr. 
Armstrong,  in  speaking  of  the  licentiousness  of  the 
natives,  observes,  "The  causes  which  lead  to  it  are  such 
as  idleness,  living  in  small  and  miserable  houses,  without 
pai'titions,  a  debased  state  of  the  moral  feelings  and  the 
licentious  conduct  of  many  foreigners." 

Let  me  again  return  to  Dr.  Chapin,  and  see  what  he 
has  to  say  in  regard  to  certain  ailments  of  the  native 
race  which  were  also,  probably,  factors  in  the  problem 
I  am  endeavoring  to  solve.  On  the  subject  of  venereal 
diseases  the  Doctor  says,  (and  in  the  absence  of 
proof  to  the  contrary  I  accept  the  statement  wdth  reser- 
vation and  subject  to  the  remarks  I  shall  hereafter 
make. )  ' '  If  it  be  a  fact,  that  the  aborigines  of  America 
were  affected  by  syphilis  and  gonorrhoea  before  Europe- 
o 


18 

aiis  visited  them,  or  if,  as  is  presumed  by  Dr.  Thomp- 
son, 'syphilis  has  been  thousands  of  times  generated 
de  novo,  by  impure  intereourses,'  it  is  certain  neither  dis- 
ease existed,  or  was  known  at  the  Sandwich  Islands  be- 
fore the  visit  of  Captain  Cook,  in  1779.  The  natives 
had  ever  lived  in  the  practice  of  ])romiscuous  and  almost 
unrestrained  iiitercourse,  so  that  the  women  were  often 
unable  to  designate  the  father  of  tlieir  children  ;  still 
their  practises  were  not  attended  with  those  conse- 
quences which  follow  the  licentious  m  all  civilized 
countries.  Those  who  have  the  credit  of  the  discovery 
of  the  islands,  and  of  exhibiting  first  to  the  astonished 
gaze  of  the  simple  and  ignoi-ant  natives,  some  of  the 
ingenious  and  useful  implements  of  enlightened  lands, 
•H-  ^  4c-  xnust  also  receive  the  credit  of  having  intro- 
duced among  these  islanders  two  of  the  vilest  and  most 
loathsome  diseases  evei'  sent  as  a  punishment  for  trans- 
gression. And  upon  the  same  page  on  Avhich  is  re- 
corded the  benevolent  efforts  made  to  improve  their 
condition  and  circumstances,  "^  ^  let  it  also  be  re- 
corded that  they  entailed  upon  their  beneficiaries,  a  dis- 
ease wdiich  has  'grown  with  its  grow^th  and  strength- 
ened with  its  strength,'  which  has  extended  its  coui-se 
with  destruction  and  death,  till  all  portions  of  the  group 
have  become  infected,  and  countless  multitudes  have 
fallen  victims  to  its  power.  With  such  an  introduction, 
the  venereal  disease  has  foi^  the  past  fifty-seven  years 
continued  to  spread  and  increase ;  perpetuated  and  ex- 
tended too  by  almost  every  vessel  Avhich  touched  at  the 
islandSj  till  words  Avould  fail  to  express  the  wretched- 
ness and  woe  which  have  been  the  result.  Foul  ulcers, 
of  mani)  years  standing^  both  indolent  and  phagedenic,  everg- 
iuhere  ahound^  and  visages  horrihlg  deformed — eyes  rendered 
hlind,  noses  entirely  destroyed,  months  monstrously  draivn  aside 
from  their  natural  ijosition,  ulcerating  joalates,  and  almost  use- 
less arms  and  legs,  mark  most  clearly  the  state  ami  pro- 
gress of  the  disease  among  that  injured  and  helpless 
people.  I  have  seen  more  than  one  case  of  marasmus 
iu(Jueed  by  the  difficulty-  of  mastication  and  dc^luti- 


19 

tion.  The  mouths  of  these  patients  were  ahnost  closed 
in  the  process  of  cicatrization,  and  the  gums  and  fauces 
were  destroyed  by  ulceration.  In  one  of  my  ])atients 
suffering  with  the  secondary  symptoms  of  the  disease, 
in  which  I  Avas  successful  in  stopping  its  progress  by  a 
mercurial  course,  the  external  nose  had  entirely  disap- 
]jeared,  and  its  place  w^as  occupied  l^y  a  concavity  and  a 
foramen  of  an  irregulai'ly  oblong  form.  The  left  eye 
Avas  totally  blind,  and  ])oth  disfigured  l)y  ulceration  as 
almost  to  lose  their  identity.  The  mouth  was  shock- 
ingly deformed ;  the  lips  and  alveolar  processes  mostly 
removed  l)y  absorption,  and  the  teeth  having  theii'  necks 
and  a  portion  of  their  roots  divested  of  integuments, 
Avere  irregular  in  their  distances  and  positions,  pointed 
in  every  direction,  and  but  slendeiiy  adapted  to  the 
purposes  of  utility.  The  Avhole  countenance  Avas  dis- 
ligured  l)y  deep  eschars,  and  the  body  greatly  emaciated ; 
no  food  could  be  masticated  by  him,  so  bad  was  the 
condition  of  his  mouth.'' 

In  regard  to  cutaneous  diseases  and  scrofula,  the 
Doctor  says:  ''Though  the  Saurhvich  Islanders  are  re- 
markably fond  of  the  Avater  and  are  fastidiously  particu- 
lar in  their  practices  of  Avashing  and  bathing,  they  are, 
nevertheless,  extremely  filthy  and  sqiudid  in  many  of 
their  habits  of  life.  With  their  beasts  and  foAvls  in  the 
same  habitation,  and  not  unfrequently  on  the  same  mats 
with  themselv^es,  their  often  repeated  ablutions  Avill  l)e 
regarded  as  timely.  The  kapa,  or  native  cloth,  used 
bA^  the  inhabitants  is  Avorn  without  cleansing  till  haA^ng 
become  foul  Avith  dirt  and  vermin,  and  too  i*agged  to 
serv^e  longer  the  pui-poses  of  covering  or  protection,  it 
is  lain  aside.  Hence  diseases  induced  or  exacerbated 
by  such  causes  have  at  those  islands  a  fruitful  soil  and 
flourish  luxuriantly.  The  itch  is  extremely  prevalent, 
and  often  assumes  a  virulence  unseen  i;i  this  countrA^ 
the  pustules  sometimes  becoming  confluent  are  con- 
verted into  large  and  troublesome  ulcers.  Other  scabi- 
ous affections  exist.  Scrofula  is  not  only  frequent  but 
extremely  malignant . ' ' 


20 

Now  let  me  turn  again  to  Mr.  Wyllie's  report  in  this 
connection,  and  examine  the  replies  to  the  question  re- 
garding diseases  prevailing,  contagious  or  epidemic,  but  be- 
fore so  doing  I  desire  to  say  a  few  words  parenthetically 
to  the  foreign  readers  of  this  report.  For  many  years 
the  Hawaiians  have  been  presented  to  the  world  as  be- 
ing inordinately  licentious,  utterly  profligate,  absolute- 
ly abandoned  and  worthless  in  character  and  wholly 
deficient  in  moral  principles.  The  responsibility 
for  this  gross  defamation  of  character,  by  care- 
less exaggeration,  must  rest,  in  a  large  measure, 
upon  those  from  whom  I  quote  and  their  associates, 
friends  and  correspondents.  It  must  be  remembered 
that  they  were  men  of  a  strictly  religious  turn  of  mind, 
more  adamantine  in  pulpit  and  print  against  every  in- 
fraction of  the  divine  or  moral  law  than  the  God-man 
Himself  whose  teachings  they  came  to  impart.  They 
judged  an  indigenous  aboriginal  race  sinning  in  ignorance, 
and  learning  the  sin  of  sinning  from  white  sailors,  whom 
they  at  first  regarded  as  equals,  if  not  superiors,  in 
power  and  knowledge  to  their  would-be  spiritual  bene- 
factors, as  if  these  poor,  generous,  hospitable,  loving 
and  ignorant  natives  had  had  opportunities  of  learning 
to  be  immaculate  and  holy.  The  hardworking  mission- 
aries were  few,  and  the  libidinous  foreign  sailors  num- 
bered by  the  thousands,  and  while  the  one  aimed  to 
teach  an  entire  change  of  life,  manners,  dress  and  cus- 
toms ^\it\\  a  somewhat  severe  and  repressive  hand,  the 
other  offei'ed  pleasure  and  profit  unrestrained  by 
thoughts  of  future  pain  and  punishment.  No  more 
should  the  blame  of  sin,  disease  and  defects  in  charac- 
ter be  thrown  upon  the  native  race  than  the  Ci*edit  of 
their  present  high  degree  of  intelligence  and  advance- 
ment should  be  entirely  given  to  their  spiritual  teachers. 
The  intellectual  and  material  progress  and  the  disease, 
and  such  debasement  as  may  exist,  must  be  accredited  to 
foreign  influence,  to  the  teachers  on  the  one  hand  and 
to  the  licentious  white  men  on  the  other.  Nor  does 
this  latter  class  include  sailors  alone,  but  even  at  the 


21 

present  day  it  is  largely  made  up  of  young  white  men 
whose  family  antecedents  and  position  in  life  should 
make  them  defenders  instead  of  destroyers  of  the  native 
race . 

But  to  resume,  Mr.  Coan  says:  ''the  principal  dis- 
eases are  of  the  venereal,  scrofulous  and  cutaneous 
character.  The  climate,  however,  is  remarkably 
healthy."  Mr.  Green  says  that  no  diseases  prevail 
contagiously  or  epidemic  in  his  district  (Makawao). 
'"  Occasionally  the  influenza  prevails  ;  bu^"  on  the  whole, 
since  I  have  resided  among  these  people,  they  have 
been  exempted  from  diseases  to  a  remarkable  extent." 
Mr.  Bishop  says  :  '^'No  contagious  diseases  except  cutan- 
eous eruptions  which  are  very  prevalent  and  distressing. 
*  ^  *  But  the  most  prevailing  and  mortal  diseases 
are  consequent  upon  the  venereal  corruption  of  the 
blood."  Mr.  Emerson  says,  "the  itch  and  venereal 
diseases  are  destructively  contagious.-' 

It  may  not  be  amiss  to  say  here,  that  the  opinions  I 
have  quoted  were  written  when  the  native  race  num- 
bered three  or  four  times  more  than  the  present  popula- 
tion of  40,000,  and  that  sixty  years  before  they  were 
computed  at  ten  times  as  many. 

But  there  is  anothei'  dark  chapter  to  be  written  before 
I  pass  on  to  the  next  chain  in  the  link  of  tracing  cause 
and  effect,  and  again  I  quote  from  Mr.  Wyllie's  report. 
The  question  asked  is  :  "  How  far  is  it  (physical  health) 
affected  by  the  enervating  effects  of  indolence  and  in- 
difference, as  to  anything  beyond  the  mere  wants  of 
animal  existence?"  Mr.  Coan  replies:  "Physical, 
mental,  and  moral  imbecility ;  disease  and  vice  are  ex- 
tensively engendered,  and  sadly  perpetuated  by  indo- 
lence and  indifference  to  anything  beyond  the  mere 
wants  of  animal  existence."  Mr.  Green  says  :  "Great- 
ly affected.  ^LSTothing  compared  with  these,  as  a  source 
of  suffering,  both  moral  and  physical.  Here  is  the 
fruitful  source  of  vice,  misery  and  death.  The  nation 
is  rusting  out. ^"^  Mr.  Clark  says  ;  "Indolence  here,  as 
everywhere,  has  a  debasing  influence  on  the  moral  and 


22 

)3hysical  condition  of  the  pepple.  It  is  the  mother  of 
vice  and  disease.  As  artificial  wants  increase,  the 
character  of  the  people  is  generallj^  elevated.-'  Mr. 
Parker  says,  "Both  the  moral  and  physical  health  of 
the  natives  is  mast  serionsly  affected  (injured)  hj'  their 
indiffei'ence  and  improvidence.''  Mr.  Bishop  says: 
"'Indolence  is  attended  with  enervating  effects  on  the 
constitution.  This  is  evinced  in  the  females  Avho  have 
little  to  do,  and  yet  they  are  more  subject  to  sickness 
than  the  men.  Perhaps  there  are  other  causes  pro- 
ductive of  sickness  in  many  females  ;  the  consequences 
of  vicious  idleness.''  Mr.  Emerson  says :  ''This  peo- 
ple are  indolent,  and  many  of  them  improvident ;  and 
sickness  and  death  are  often  the  result  of  this  improvi- 
dence. They  have  no  beds  for  the  sick,  and  no  suit- 
able food  or  diet  in  such  cases.  Their  houses,  mats  and 
sleeping  places  often  generate  disease,  and  prevent  the 
effects  of  suitable  remedies,  if  administered,  and  often 
deter  from  the  attempt  to  administer  remedies  that 
would  be  suitable,  if  cii'cumstances  would  allow  of  their 
use.  But  whether  this  indolence  and  improvidence  are 
peculiarly  inherent  in  the  Sandwich  Islands,  or  the  re- 
sult of  a  system  of  oppression  long  practised,  in  con- 
nection with  the  al)sence  of  that  stimulus  produced  by 
the  artificial  and  imaginary  wants  connected  with  civili- 
zation is  yet  to  be  proved."  Mr.  Gulick  says  :  ''Very 
injurious,  and  to  a  considerable  extent.  Yet  this  in- 
difference appears  to  be  merely  the  result  of  the  system 
by  which,  till  recently,  they  were  deprived  of  nearly  all 
their  rights,  and  thereby  precluded  from  the  hope  of 
materially  bettering  their  condition."  Mr.  Johnson 
only  says  :  "  I  think  the  moral  and  physical  health  of 
this  people  is,  in  some  degree,  injured  by  indolence  and 
indifference  to  the  wants  of  both  bodv  and  soul." 


23 


WHENCE  THE  DISEASE  AVAS  DETilVED. 

In  my  report  to  your  Plonorable  Body,  in  1881,  I 
said :  "I  beg  to  lu-ge  that  Hawaii  take  a  larger  pai't  in 
pursuit  of  such  researches.  She  is  attacked  by  a  terri- 
ble enemy.  Let  her  study  everything  pertaining  to  its 
origin,  resources,  and  favorable  conditions.  Lej)rosy 
has,  at  times,  attacked  every  race  in  the  world;  but  its 
chief  abiding  places  have  been  parts  of  Asia.  Some  of 
the  islands  of  ^falaysia  have  also  been  fecund  hot-beds 
of  the  fell  disease.  In  Java,  and  other  islands  of  the 
great  Archipelago,  where  the  natives  present  most 
striking  affinities  with  the  Hawaiian  race,  the  diseases 
that  affiict  them  also  afflict  the  Hawaiians.  The  Ja vans 
treat  as  outcasts  all  Avho  are  suffering  with  the  huUg.  oi* 
leprosy,  and  the  unfortunate  ones  have  voluntarily  seg- 
regated themselves  upon  small  islands,  where  they  are 
supphed  with  the  means  of  subsistence  by  their  friends.'' 
I  added,  and  I  am  still  of  the  same  ophiion,  that,  ''I 
think  it  would  be  well  that  the  disease  wdiich  commands 
so  large  a  share  of  public  attention,  and  calls  for  so 
large  an  appropriation  of  the  public  revenue  should  be 
studied  by  competent  authorities  under  Hawaiian  aus- 
pices in  various  parts  of  Malaysia  and  Polynesia,  where 
it  is  to  be  found." 

I  do  not  purpose  to  enter  into  a  long  ethnological  dis- 
cussion to  trace  the  orio-in  of  the  disease  in  this  country, 
or  if  not  its  origin,  a  possible  source  for  it,  but  I  cannot 
refrain  from  touching  upon  the  subject  in  partial  con- 
nection with  the  origin  of  the  Hawaiian  race  and  the 
existence  of  leprosy  in  India  from  the  most  ancient 
times,  as  presented  by  the  very  valuable  series  of  re- 
ports furnished  by  Her  Imperial  Majesty's  Govern- 
ment  of  British  India  to  His  Majesty's  Govei'nment. 

My  views  on  the  origin  of  the  Hawaiian  and  ^ialay- 

sian  races  have  been  published  and  are  known  to  those 

who  take  an  interest  in  such  subjects.     While  they  may 

"l    differ  in  a  degree  they  coincide  in  the  matei-ial  point  of 

origin  with  those  of  Judge  Foniandcrj  who  in  his  Avorli 


24 

on  the  Polynesian  race,  says  :  ^'  I  believe  I  can  show  that 
the  Polynesian  family  can  be  traced  directly  as  having 
occnpied  the  Asiatic  Archipelago  from  Samatra  to 
Timor,  Gilolo,  and  the  Philippines,  previous  to  the  oc- 
cupation of  that  Ai-chipel  by  the  present  Malay  family ; 
that  traces,  thought  faint  and  few,  lead  up  through 
Deccan  to  the  northwest  pai't  of  India  and  the  shores 
of  the  Persian  Gulf;  that,  when  other  traces  here  fail, 
yet  the  language  points  farther  north,  to  the  Aryan 
stock  hi  its  earlier  daj^s,  long  before  the  Vedic  irruption 
in  India ;  and  that  for  long  ages  the  Polynesian  family 
was  the  recipient  of  a  Cushite  civihzation,  and  to  such 
an  extent  as  almost  entirely  to  obscure  its  own  con- 
sciousness of  parentage  and  kindred  to  the  Aryan 
stock.-'  And  again,  ''I  hope  to  be  enabled  to  show 
that  the  Polynesian  family  formerly  occupied,  as  their 
places  of  residence  the  Asiatic  Archipelago,  and  were 
at  one  time  in  the  world's  history  closely  connected  by 
kindred,  commerce,  or  by  conquest  with  lands  beyond, 
in  Hindustan,  the  shores  of  the  Persian  Gulf,  and  even 
in  Southern  Arabia.'' 

The  Secretary  to  the  Government  of  India  states 
that  at  the  present  day  ''there  appears  to  be  at  least 
three  centers  of  comparatively  intense  prevalence,  viz  : 

{a)  The  Beei'bhoom  and  Bancoora  districts  hi  the 
districts  in  the  lower  provinces  of  Bengal ; 

(h)  The  Kumauii  district  in  the  Northwestern 
provinces ; 

(c)  The  Deccan  and  Konkan  in  the  Bombay  and 
Madras  Presidency,  respectively." 

In  other  words  that  in,  and  surrounduig  the  cradle, 
from  which  the  great  and  ancient  races  from  whose 
loins  were  dei'ived  the  Hawaiian s,  the  disease  still  pre- 
vails in  the  strongest  form.  Turning  to  page  80  of  the 
Indian  Peport,  I  find  a  statement  by  Messrs.  Lewis 
and  Cunningham,  Assistants  to  the  Sanitary  Commis- 
sioner of  India,  that  ''  the  disease  has  been  known  to 
exist  in  India  for  at  least  3,000  years,''  but  "  with  re- 
gard to  our  definite  Ivuowledgc  of  its  actual  causation, 


25 

it  is  to  be  feared  that  we  have  not,  except  phraseologi- 
cally,  advanced  very  much  on  the  etiological  views  re- 
coi'ded  by  Atreya  many  centuries  before  the  Christian 
era,  which  were  to  the  following  effect:  "  When  the 
seven  elements  of  the  body  become  vitiated  through  the 
irritation  gf  the  wind,  the  bile  and  the  phlegm,  they 
affect  the  skin,  the  flesh  and  the  spittle,  and  the  other 
humours  of  the  body.  These  seven  are  the  causes  re- 
spectively of  the  seven  varieties  of  knshta  (leprosy) — 
the  kiidig  of  the  Japanese.  This  Atreya  lived  at  least 
2000  years  before  the  Christian  era,  and  wrote  the 
"  Charaka  Sanpita  on  the  pathology  of  the  disease," 
extracts  fi-oin  which  will  be  found  on  the  pages  above 
quoted.  In  these  extracts  he  describes  the  various 
kinds  of  leprosy,  the  descriptions  of  which  are  already 
recognizable  as  forms  of  disease  existing  at  the  present 
day.  He  says  :  ''  the  kiishta  thus  produced  cause  much 
pain  and  suffering.  None  of  these  varieties  result, 
however,  from  the  vitiation  of  a  single  humour.  Kush- 
tas  are  of  seven,  of  eleven,  or  a  larger  number  of  a 
kind :  and  these  constantly  irritating  the  system  be- 
come incurable.  "^  ^  ^  The  wind,  the  bile,  and  the 
phlegm,  being  vitiated,  re-act  on  the  skin,  &c.  When 
the  wind  is  most  vitiated  it  produces  the  kadala  kiishta^ 
the  bile,  the  aiidumbara,  the  phlegm  the  mandala^  the 
wind  and  the  bile  the  rishyajihva,  the  bile  and  the 
phlegm,  and  the  wind  the  sidhma^  and  the  three  to- 
gether the  kakanaka,^-  The  causes  of  the  disease  At- 
reya gives  as  being :  ' '  Excessive  physical  exercise 
after  exposure  to  too  much  heat  or  too  much  cold ; 
taking  food  after  surfeit;  eating  of  fish  with  milk; 
using  barley  with  several  other  grains,  such  as  '  haya- 
naka,'  '  dalaka,'  ^  karsdusa,'  &c.,  along  with  venison, 
milk,  curdled  milk  and  butter  milk ;  excessive  sexual 
intercourse  ;  long  protracted  excessive  fear  or  labor ; 
fatigue,  interruption  of  catarrah,  &c.,  vitiate  the 
phlegm,  the  bile,  and  the  wind ;  hence  the  skin  and 
the  three  others  become  slackened.  Thus  iriitated, 
the  thre«  elemeatft  corrupt  the  skin  and  others,  and 
4 


26 

produce  '  kushta/  The  premonitory  symptoms  of 
'  kuslita  '  are  as  follows  :  Want  or  excess  of  perspira- 
tion, I'oughness,  di>scoloi*ation,  itching  and  insensi- 
hility  of  the  skin,  [)ain,  honipitation,  eruption,  and  ex- 
cessive pain  on  tlie  pails  that  are  a]:>out  to  fall  off.'' 
''  The  worms  that  form  in  leprous  eruptions  destroy  the 
jiesh,  skin,  veins,  muscles,  and  bones.  When  affected 
by  them,  the  patient  snffers  from  spontaneous  dis- 
charges of  blood,  insensibihty,  loss  of  sensibility  of  the 
skin,  mortification,  thirst,  fever,  dysentery,  burning, 
weakness,  disrelish  and  indigestion.  The  H^ushta ' 
becomes  incurable." 

THE    LEPKOSY    OF    THE    I3IBLE. 

As  regai'ds  the  Biblical  leprosy  as  defined  by  Moses 
in  Leviticus,  this  might  have  been  deiived  from  the 
same  original  source.  The  book  of  Leviticus,  accord- 
ing to  accepted  dates,  w^as  written  snbsequent  even  to 
that  of  Atreya  by  several  centui'ies,  and  fi'om  quota- 
tions in  the  latter' s  writings  it  is  certain  that  he  w^as 
the  earliest  writer  on  the  subject.  The  disease  might 
have  been  introduced  by  the  great  migratory  race 
founders  into  Arabia  and  thence  into  I'^gypt,  and  pro- 
pagated among  the  Israelites  during  their  bondage  to 
the  Egyptians,  since  we  find  in  Deuteronomy,  chapter 
28,  V.  27,  the  threat  implying  the  fear  and  knowledge 
of  the  disease,  "  the  Lord  will  smite  thee  with  the  botch 
of  Egypt,  and  with  the  emerods,  and  wiHi  the  scab, 
and  with  the  itch,  tvhereof  thou  canst  not  he  healed.'^''  It  is 
not  easy  to  decide  from  the  Mosaical  description  of  the 
disease  whether  the  leprosy  referred  to  was  the  'kushta,' 
or  some  of  the  other  varieties  such  as  leucoderma,  or 
white  skin,  but  from  the  verse  just  quoted  I  am  in- 
clined to  think  that  it  existed  even  in  its  most  deadly 
form.  It  will  be  noticed  throughout  the  Bible,  that  it 
was  invariably  treated  as  an  unclean  disease,  and  one 
for  which,  in  addition  to  obedience  to  the  sanitary  com- 
mands of  the  Pnest,  sacrificial  atonement  had  to  be 
made,  as  if  for  a  violation  of  the   moi'al  an  well  a>^  phy- 


27 

sical  sanitary  laws.  1  am  also  inclined  to  believe  that 
it  was  more  than  a  common  cutaneons  affection  and 
was  considered  to  be  both  contagious  and  infectious,  for 
not  onh'  were  the  lepers  set  apart  from  the  clean,  but 
their  clothing  and  even  their  homes  were  destroyed. 
That  the  Jews,  as  the  world  grew  older,  gradually  be- 
came freer  from  the  loathsome  malady  is  probably  due 
to  their  hygienic  laws  being  far  stricter  than  those  of 
the  other  nations  with  whom  they  were  bi'ought  into 
contact  in  their  wanderings,  either  as  a  nation,  sections  ■' 
of  a  nation,  or  as  individuals.  It  is  more  than  probable 
I  think,  that  the  germs  of  the  disease,  too,  were  being  ^ 
insidiously  spread  through  Europe  by  the  adventurers, 
navigators,  discoverers  and  conqueroi's,  developed  by 
these  ancient  races  long  before  the  Crusades,  the  ac- 
cepted modern  date  of  its  inti^oduction  into  Europe. 

HEEEDITAF.Y    TIIAXSMISSIOX    OF    TIIK    DISEASE. 

Messrs.  Lewis  and  Cunningham  state  ''that  the 
inhabitants  of  the  Kumaun  districts  virtually  consist  of 
two  classes  only — Rajputs  and  Domes,  the  former 
representing  an  Aryan  population,  the  latter  an  abori- 
ginal people — whilst. other  classes  are  only  very  spar- 
ingly represented,''  and  that  in  their  cases,  ''the 
evidence,  such  as  it  is,  is  in  favour  of  impartial  distribu- 
tion of  the  disease,''  but  on  the  question  of  the  heredity 
of  the  disease  they  say  the  evidence  they  produce  from 
the  Almorah  Asyliun,  "allowing  the  fullest  play  to  the 
possible  influence  of  similarity  of  external  conditions, 
points  to  the  distribution  of  the  disease  by  families  and 
therefore  to  heriditary  predisposition."  They  support 
their  position  by  statistics  which  ver}'  strongly  endorse 
similai-  view^s  of  other  writers. 

In  view  of  the  inunense  mass  of  testimony  pro  and  eon 
in  regard  to  the  hereditary  transmission  of  the.  disease 
Avhich  forms  part  of  my  repoi't,  and  yet  which  I  think, 
in  the  main,  will  support  to  no  little  extent  the  view  of 
a  latent  race  j^redisposition  in  individuals  of  that  race 
capable  of  being  developed  under  conditions  favorable 


28 

to  the  germinating  of  the  disease  germs  I  will  pass  on 
to  the  consideration  of  what  has  been  observed  in  the 
descendants  of  the  more  ancients  races,  and  of  the 
more  direct  cognate  races  of  the  Hawaiians,  not  the 
modern  Malays  wdio  are  scarcely  older  in  Malaysia  than 
the  Normans  of  the  English  conquest  in  England,  but 
to  the  more  ancient  stock  such  as  the  Sundees,  the 
Timorese  and  the  ancient  people  of  the  Moluccas. 
These  were  recognized  as  the  aborigines  of  the 
Country,  whose  language,  religion,  habits  and  ideas 
bear  a  stronger  resemblance  to  those  of  Polynesia  than 
any  others  of  insular  Asia,  and  among  them  to  this  day 
we  find  the  same  disease,  as  the  Hawaiians  are,  and 
have  been,  subject  to.  Here  leprosy  has  been 
known  for  generations  and  a  sj^stem  of  voluntary  seg- 
regation carried  out.  That  is  to  say,  lepers  resorted  to 
certain  islands  Avhere  they  were  occasionally  visited  by 
their  friends  who  brought  them  their  means  of  subsist- 
ence. In  Tahiti,  also,  to  judge  from  the  description  of 
travelers,  a  form  of  leprosy,  or  of  elephantiasis,  was 
known  at  least  a  hundred  years  ago. 

Thus  far  I  have  endeavored  to  show  that  should 
leprosy  be  a  disease  upon  which  the  influence  of  race 
has  any  effect,  that  influence  must  necessarily  have  its 
effect  upon  the  Hawaiian  race  as  the  descendants  and 
conquerors  of  those  in  whom  the  earliest  seeds  of  that 
disease  were  implanted,  and  through  Avhom,  for  gene- 
rations after  generations,  the  seed  I'ipened  and  was  re- 
implanted.  In  supporting  this  theory  it  is  not  neces- 
sary to  hold  that  the  sequence  would  be  that  the  whole 
race  should  be  diseased  or  even  pre-disposed  to  disease, 
for  we  find  that  there  is  evidence  from  all  parts  of  the 
world  that,  owing  to  circumstances,  or  perhaps  in  the 
absence  of  the  necessaiy  infiuences  to  nourish  disease, 
the  non-resistants  are  in  a  lai-ge  majority.  As  a  rule, 
too,  the  evidence  shows  that  while  the  chiefs,  and  the 
'^  better  classes"  are  occasionally  attacked,  the  poorer, 
and  practically  servile  classes,  badlj^  educated,  sparsely 
clothed,  ill-fed,  and  wretchedly  housed,  form  the  im- 
mense majority  of  the  victims* 


29 

WHAT,    THEN,    IS    LEPROSY  ? 

If  aslved  my  opinion  of  leprosy  and  how  it  originated,  | 
I  will  reply  with  the  pi'oper  modesty  of  a  layman, — not 
altogether  mifamiliar  with  medical  works  on  the  subject, 
nor  altogether  miexperienced  with  the  disease  in  this 
and  other  countries — in  the  presence  of  learned  pro- 
fessional and  scientific  observers  and  writers,  I  do  not 
know,  nor  appai-ently  does  any  one,  but  I  think  that  in 
all  probability  it  is  a  disease  caused  in  its  earliest  inci- 
piency  by  a  demoralization  of  the  system  by  uncleanli- 
ness,  not  merely  of  the  surface  of  the  body, — for  w^e 
find  in  India,  especially,  that  some  races  that  never 
wash  enjoy  an  immunity  from  the  disease — but  of  the 
blood,  poisoned,  perhaps,  to  a  very  great  extent  by  a 
degraded  condition  of  living,  or  by  excessive  indul- 
gence of  the  animal  nature  in  a  tropical  climate  ;  for, 
so  far  as  my  reading  extends,  I  may  be  permitted  to 
say  that  the  disease  was  not  only  originated  in  but  has 
thriven  better  in  hot  than  in  cold  climates;  the  excep- 
tions of  Xorway  and  TsTew  Brunswick  are  comparatively 
minor  ones  in  proportion  to  the  leper  populations  of  the 
tropical  Avorld. 

While  I  am  not  prepared  to  consider  the  medical 
question  of  the  relation  of  leprosy  to  syphilis,  I  am  in- 
clined to  believe,  and  to  say,  that  syphilitic  blood  pois- 
oning has  played  no  small  part  in  the  development  of 
the  disease  in  these  Islands,  in  connection  with  the  m- 
herited  disease  and  "constitutional  taints''  of  the  Isl- 
anders, such  as  are  mentioned  in  the  earlier  portion  of 
my  report.  I  think  that  the  mind,  also,  is  no  unimpor- 
tant factor  in  aiding  the  propagation  of  the  disease.  I 
see  no  reason  why,  in  the  scheme  of  the  Great  Creator, 
the  human  body  should  not  be  placed  on  the  same 
plane  as  the  members  of  the  animal  and  vegetable 
world  in  its  relation  to  health  and  disease.  Any  gar- 
dener knows  that  by  cultivation  he  can  improve  his 
flower  and  fruit,  and  by  care  and  grafting  and  selection 
of  seedlings  create  ne^v  varieties,  and  from  a  sorry  crab 


30 

apple  grow  a  Blenheim  orange,  or  by  the  reverse  pro- 
cess, by  mipoverished  soil,  thriftless  untidmess  and 
nncleanliness  deteriorate  the  plant  or  tree,  poison  not 
only  its  flowers  and  leaves  through  the  sap  but  allow 
its  bark  to  become  the  refuge  and  home  of  insects  and 
fungi.  The  nnhealthy  plant  not  only  produces  no 
frnit  but  dies  the  lingering  death  of  a  leprons  human 
being.  And  so  it  is  with  animals,  inbreeding,  or  breed- 
ing with  inferior  stock  deteriorates  the  original  stock 
and  the  weak  puny  animals  succnmb  to  influences 
which  the  stronger  resist. 

But  with  this  inscrutable  malad}^  of  leprosy,  as  Dr. 
Tache,  of  Tracadie,  says  :^  *'  There  are  some  instances 
of  such  a  slovj  proc/ress  and  such  an  attenuated  malignity  of 
the  ailment  that  life  and  even  fair  health  are  enjoyed 
for  many  years,''  and  as  Dr.  Vandyke  Carter,'  in  speak- 
ing of  the  Xorwegian  lepers,  says  if  ''But,  while  the 
coast-dwelling  peasantry  of  Xorway,  in  comparison 
with  other  (not  all)  countries  of  Europe,  have  admittedly 
long  dwelt  in  a  backward  hygienic  condition,  living 
much  on  fish  and  potatoes,  intermingling  freely  and 
being  subject  to  overcrow^hng  dui'ing  their  long  win- 
ters ;  still,  on  the  other  hand,  it  is  notorious  that  they 
are  an  unusually  well  developed  and  long-lived  race  ; 
and  besides,  individual  lepers  are,  as  often  as  others, 
even  robust  people,"  and  yet,  to  quote  Dr.  Moore,  the 
leper  must  be  in  "a  state  of  human  system  below  par," 
and  therein  in  spite  of  the  apparent  strongly  built  phy- 
sical frame  lies  the  wdiole  secret  of  the  disease,  and  its 
remedy, — a  remedy  not  for  the  generation  inheriting  it, 
but  for  the  survivors,  not  only  for  the  absolutely  healthy 
ones  but  also  for  those,  even,  in  whom  the  disease  germs 
may  be  l3nng  dormant,  only  waiting  to  be  destroyed  by 
wise  and  sanitar}^  culture  or  to  be  nourished  into  viru- 
lent life  by  baleful  encouragement. 


*Page  137,  Foreign  Reports. 
fPage  91,  Foreign  Reports. 


:r\ 


A  PROBABLE  CAUSE  FOR  JTS  SUDDEN  DEVELOPMENT. 

Having  thus  far  endeav^ored  to  show  that  the  disease 
has  been  possibly  dormant  in  the  Hawaiian  blood  for 
many  centuiies,  appearing-,  probably,  in  individual  cases 
to  a  greater  or  less  degree  before  Ave,  of  a  foreign  race, 
w^ere  brought  into  contact  with  them,  let  me  now  pro- 
ceed to  give  my  reasons  for  its  apparently  unexpected 
outbreak  twenty  or  thirty  years  ago,  or  at  the  era  when 
it  was  first  brought  to  the  cognizance  of  the  Hawaiian 
Cxovernment. 

Accepting  Fornander's  views  that  'Hhat  branch  of 
the  Polynesian  family,  from  which  the  oldest  ruling  line 
of  HaAvaiian  chiefs  claim  descent,  arrived  at  the  Hawaii- 
an group  during  the  sixth  centurj^  of  the  Christian  era," 
Ave  have  a  history  of  nearly  eleven  centuries  of  a  race 
living  in  practical  non-contact  w^ith  a  white  population. 
And  furthermore  of  a  i*ace  Avhich  was  in  earlier  times 
according  to  Mr.  Horatio  Hale  so  prolific  that  it  threw 
off  its  ''too-i*edundant  population  by  migratory  expedi- 
tions"' to  various  islands  of  the  Pacific,  to  Easter  island 
and  the  HaAvaiian  group  for  instance,  and  occupied 
' '  ovei'  three  thousand  years  for  this  gradual  process  of 
redundancy  and  relief." 

Cook  and  the  earher  Avriters  estimated  the  population 
of  the  Hawaiian  group,  onl}^  a  little  more  than  a  cen- 
tury ago,  at  nearly  half  a  million  inhabitants.  These 
people  Avere  practically  gOA^erned  as  Avere  Eui'opeans  in 
the  earliest  and  most  tyrannical  days  of  early  feudalism. 
Their  lives,  a irtue  and  property,  such  as  a  semi-servile 
feudal  class  might  possess,  were  at  the  mercy  and  will 
of  the  chiefs  from  the  highest  to  the  loAvest  in  turn. 
Their  food  must  necessarily  have  consisted  principally 
of  a  vegetable  and  fish  diet,  Avith  swine  and  dogs,  or 
some  small  animals  for — since  cattle  were  unknow^n  be- 
fore the  adA^ent  of  foreigners — animal  food,  and  for  a 
beverage,  Av-ater  or  products  of  roots,  bark,  etc.  They 
were,  how^ever,  in  their  primitive  style  of  living,  strong, 
robust  and   he^jiJthy,   living  and   loving  as   sons  and 


32 

dauo'htei's  of  the  sun  and  Bea,  but  intermarrying  and 
inbi'eeding,  as  passion,  or  caprice,  dictated.  Of  theii- 
diseases  we  have  no  rehabie  record  at  hand,  but  it  is 
not  unreasonable  to  presume  that  they  possessed  the 
morbific  taints  of  their  ancestors,  and  their  ills  were 
treated  much  in  the  same  way  as  in  the  earlier  days  of 
the  transition  period  by  the  native  kahunas^  or  doctors 
and  soi'cerers  ;  a  treatment  which  apparently  was  a  trust 
in  the  native  Gods  and  the  resistant  powers  of  the 
patient,  assisted  by  a  rude  knowledge  of  the  medicinal 
power  of  herbs,  roots  and  earths. 

THE  LATEXT  FLAME  BURSTS  FORTH. 

The  first  spark  that  ignited  the  latent  flame  of  disease 
and  death  was  undoubtedly  the  arrival  of  the  first  for- 
eign ship — be  it  Capt.  Cook's  or  another's.  It  is  un- 
necessary to  repeat  the  statements  of  early  writers  as  to 
the  rapidity  with  which  the  poor,  ignorant,  simple  and 
innocent  minded  natives  were  impregnated  with  one  of 
the  most  foul  and  loathsome  diseases  that  nature  has 
inflicted  upon  man  for  outraging  her  laws.  The  dis- 
ease was  sown,  and  being  neglected  it  increased  in  ma- 
lignity and  virulence,  as  it  was  passed  around  promis- 
cuously from  body  to  body.  ]S^o  merc}^  was  shown  to 
any,  the  women  flocked  to  the  sea  ports,  the  wdiite 
Gods,  so  regarded  by  these  unhappy  creatures,  passion- 
ate, reckless  and  unscrupulous,  after  their  long  voy- 
ages and  abstinence,  sacrificed  them  by  the  hundreds  to 
the  bloody  Moloch  of  their  lusts.  Inbred  by  genera- 
tions, reinvigoi-ated  by  the  pestiferous  embraces  of 
thousands  of  white  men  it  became  perpetuated  in  the 
blood  of  those  who  yielded  to  temptation.  When  I  re- 
member that  in  the  last  75  years  at  least  a  quarter  of  a 
miUion  of  men,  of  the  white  race  principally  sailors,  in 
visiting  the  shores  of  these  islands  have  indulged  in  un- 
resti-ained  intercourse  with  the  poor  women  of 
these  islands,  I  am  not  surprised  at  the  reduction  of  the 
po])ulation  so  much  as  the  fact  that  so  many  remain, 
Bear  in  mind,  tocN  thai  ^vith  th-e  bold  disorderly  life  o^ 


33 

white  men,  came  the  white  man's  poisonous  narcoticB 
and  intoxicants  to  a^'ain  change  and  enfeeble  the  blood 
of  the  race.  Mentally,  too,  the  lower  classes  were 
probably  debilitated  by  the  oppression  of  their  chiefs 
and  the  hard  and  unusual  labors  imposed  upon  them  by 
their  task  masteivs.  In  the  ruins  and  remnants  of  the 
hciaus  or  temples  may  we  not  r^ad  a  record  of  lives  lost 
and  bodily  constitutions  wrecked.  All  this  time  the 
diseased  and  blood  impoverish  id  natives  were  living  in 
their  primitive  manner  in  theii*  grass  huts,  the  general 
condition  of  which  I  have  ali'eady  described,  and  sleep- 
hig,  the  diseased  wiUi  the  healthy,  upon  one  mat  and 
under  one  tapa^  or  bark  woven  covering.  A  whole  fam- 
ily, irrespective  of  age  or  sex,  receiving  from  each 
other's  heated  bodies  the  disease-laden  or  disease-creat- 
ing exudations.  Purely  I  might  almost  stop  here  and 
claim  that  the  diseased  of  the  nation  almost  courted 
death  by  the  conditions  they  had  at  first  so  unwittingly 
accepted  and  subsequeiitly  so  unhappily  carried  out. 

THE  EFFECT  OF  THE  TRANSITION  PERIOD. 

The  next  stage  is  the  one  that  marks  the  unprece- 
dentedly  rapid  trandtion  of  the  Hawaiian  race  from  so- 
called  barbaiism  to  Chiistianity  and  civilization,  from 
the  darkness  of  heathenism  to  intellectual  life  and 
pliysical  death, — for  the  change  has  cost  the  lives  of 
hundreds  of  thousands  of  souls.  Let  me  say  that  I  am 
aware  that  in  presenting  my  views  upon  the  source  and 
])artial  cause  of  leprosy  in  the  Hawaiian  Islands,  I  am 
ti'eading  on  dangerous  ground  from  a  medical  and 
scientific  standpoint,  and  am  falling  counter  to  accepted 
liuthorities,  and  furthermore  am  pai-tially  upholding  the 
theoiy  of  spontaneity  and  syphilitic  cachexia  in  con- 
nection w^ith  race-hereditariiiess  and  predisposition.  I 
am  willing  to  accept  the  responsibilty  in  a  degree,  for  I 
think  the  facts  justify  me  in  believing  that  each  has 
had  a  marked  influence  on  the  disease  on  these  Islands, 
and  that  the  al)atement  of  the  disease  depends  to  some 
extent  upoa  their  coasideratioa. 
5 


34 

....k  that  the  aclveiit  of  tiic  foreign  missionaries 
he.  about  the  year  1820,  may  be  conveniently  ac- 
cept a  as  the  practical  iiianguration  of  the  transition 
pericJ.  It  is  not  within  the  })rovince  of  this  report  to 
describe  the  noljle  works  which  they,  and  their  suc- 
cessors of  other  civeds,  liave  done  m  the  way  of  edu- 
cating our  people.  Their  work,  in  this  regard,  justifies 
tliem.  In  promoting  the  health  of  the  ])eople  by  educa- 
tion in  sanitary  and  moral  laws  and  enlightening  the 
mind  of  the  HaAvaiian  generally,  they  have  righteously 
foUo^ved  the  precepts  of  their  Mastei*.  If,  by  the  light  of 
subs  ^juent  events,  faults  were  made  they  must  be  at- 
tribii.  ?d  to  an  error  of  judgment,  to  the  error  of  dealing 
witJ^  he  Hawaiian  race,  in  ignorance  of  the  character- 
istics and  history  of  the  I'ace,  Avith  too  firm  a  hand,  and 
too  high  a  pressure  propelling  them  on  the  road  to  ad- 
vancement. In  a  word  the  should-have-lDcen  labor  of  a 
century  Avas  condensed  into  less  than  a  generation  of 
tinK\  In  so  I'apid  a  change  in  the  life  and  character 
of  an  aboriginal  race  both  mind  and  body  must  neces- 
sarily suffer.  To  partially  clothe  a  naked  race  Avith  uu- 
congejiial  garments,  AA^orn  in  heated  rooms  and  discarded 
as  soon  as  })ossible,  entailed  u])on  the  natiA^e  race, 
a  'arge  number  of  constitution-weakening  diseases^ 
and  more  especially  in  cutaneous  forms.  Strictness  of 
life  in  public  gav^e  AA^ay  to  hidden  sin  and  deceit,  and 
reticence  of  disease  ensued  for  fear  of  disfaAor  or  pun- 
ishment. In  lieu  of  the  oppression  of  the  chiefs  came 
the  more  dreadful — to  an  aborighial  race — oppression 
of  civilization.  Foreign  intercourse  brought  new  and 
foreign  diseases,  and  the  pernicious  body  Aveakening 
customs  and  hal)its  of  foreigners.  And  all  this  time, 
too,  fresh  hoi-des  of  diseased  men  Avere  propagating 
afresh  Avith  unhealthy  Avomen  old  diseases.  The  na- 
tion's strength  had  l)een  jn'eA'ioiisly  sorely  tested  by  epi- 
demics Avhich  had  SAvept  away  theii'  tens  of  thousands 
ill  great  swaths,  showing  tliat  tlie  once  strong  bodies 
had  become  debilitated.  Small  pox  liad  been  intro- 
duced into  the  land  ujkI  claimed  its  nctims  by  the  legion. 


35 


measles  and  other  fevers  followed,  and  diseases  which, 
under  other  conditions,  would  have  lightly  passed 
through  the-  ranks  counted  then*  dead  ))y  the  scores. 
The  once  prolific  race  had  heconie  sterile.  Even  the 
population  of  142,000  in  1823  had  in  thirty  years  (1853) 
l)een  reduced  to  73,1)00,  and  in  twenty  years  more  (1873) 
to  ^(KOOO,  or  a  loss  of  86,000 — or  more  tlian  douhle  the 
present  i)opulatioji — in  fift\'  >  ears,  and  so  they  steadily 
died  off.  Is  it  a  wonder  that  as  the  living  think  of 
theii*  man}^  lost  friends  they  feel  heart  despondent  and 
hopeless,  and  jjcrhaps  too  regardless  of  the  health  of 
themselves  and  families?  Is  it  to  he  Avondered  at  that 
only  the  l)ravest  and  strongest  did  not  hecome  discour- 
aged, and  are  not  now  as  much  weakened  in  mind  as  in 
hody? 

But  there  are  two  more  causes  which,  hi  my  judg- 
ment, have  had  a  great  effect  in  the  propagation  of 
leprosy,  or  diseases  closely  allied  to  it,  although  medi- 
cally it  he  a  disease  siu-cjoicris.  The  first  was  the  ignor- 
ance of  some  of  the  early  and  unqualified  medical  prac- 
titioners who  were  permitted  to  spread  disease  hroad- 
cast,  and  to  do  irretrieva])le  injmy  Ijcfore  retrihution 
overtook  them,  hut  the  second  and  chief  cause  was 
the  indiscriminate,  and  to  my  mind  careless  vaccin- 
ation that  ])egan  ahout  1868.  It  is  stated  in  the 
records  of  the  Board  of  Health  that  a  respected 
|)hysician,  now  resident  on  the  Islands  was  informed 
that  ''the  usual  ])rice  of  25  cents  for  each  success- 
ful vaccination  was  to  he  reduced  to  12 J  cents,  as  some 
])hysicians,  here  in  Honolulu,  had  vaccinated  j^ersons, 
and  one  of  them  2,500  for  a  stipulated  sum  of  $75, — or 
3  cents  a]>iece  and  providhig  the  vaccine  virus  appar- 
ently. Dr.  A  ruing  on  page  XLIV  says  in  regard  to 
this  suhject:  'VYou  are  doubtlessly  aware  of  the  very 
]n-evalent  opinion  among  medical  men  that  the  unusually 
rapid  spread  of  the  disease  may  possibly  be  attributed 
to  the  great  amount  of  indiscriminate  vaccination  which 
has  been  carried  on  in  these  islands.  There  have,  if  my 
information  is   con-ect,   unquestionably  new  centres  of 


36 

leprosy  developed  after  vaccination  was  practiced  and 
several  old  inhabitants  have  told  nie,  how  they  them- 
selves used  no  precautions  whatever  in  vaccinating  dur- 
ing  a  small-pox  scare,  but  brought  the  lymph  directly 
from  one  arm  to  another  without  even  wiping  either 
points  or  lancet."  As  we  have  not  yet  discovered 
Avhether  the  disease  can  be  conveyed  by  hioculation,'^''' 
nor  how  long  the  germs  thus  implanted  into  the  body 
may  be  dormant  before  becoming  productive  or  de- 
stroyed, I  can  only  state  that  the  impression  is  strong 
in  the  minds  of  many  that  a  numltcr  of  cases  have  thus 
been  inoculated  with  leprosy.  As  regards  the  experi- 
mental hioculation  of  Keanu,  the  condemned  convict, 
a  report  as  to  his  pi'csent  condition  will  be  found  in  the 
Appendix. 

I  wall  now  consider  the  question  of  contagion  in  so  far 
as,  in  my  opinion,  it  bears  upon  the  spread  of  the  dis- 
ease on  these  Islands. 

THE  CONTAGION  OF  LEPROSY. 

I  think  that  the  evidence  presented  to  you  in  the 
several  reports  of  the  Board  of  Hen  1th,  and  of  the  med- 
ical staff  of  the  Government  since  the  medical  administra- 
tion of  Drs.  Hoffmann,  Hillebi'and  and  Hutchison  to 
that  of  Drs.  Mouritz,  Arning  and  others,  and  the, 
hitherto  unpublished,  cases  to  be  found  in  the  Supple- 
ment to  this  report,  justifies  thi  stand  the  Hawaiian 
Government  has  taken  in  believing  that  th?  disease,  as 
it  appears  in  this  Archipelago,  is  to  a  limited  degree 
contagions  among  the  Hawaiian  race  provided  there  are 
strong  predisposing  and  favorable  conditions  which 
create  ^'a  certain  weakness  to  resist  its  attacks."  That 
it  is  only  mildly  contagions,  and  then  only  under  the 
most  favoring  circumstances,  among  the  white  races,  is 
to  my  mind,  absolutely  proven  by  the  fact  that  the 
cases  of  leprosy  among  the  white  population  are  so  few 
in  proportion  to  tlie  number  who  have  baen  brought  into 

*  Vide  Tracadie  Report,  page  142. 


37 

the  closest  contaet  with  the  disease,  and  1  will  repeat 
here  views  exj)ress'jd  on  the  (Ivdicatioii  of  the  Kapiolani 
Home:  ''1  have  no  hesitation  in  saying  that  the  ques- 
tion (of  contagion)  is  one  that  has  a  remoter  interest 
than  what  is  popularly  entertained,  especially  abroad, 
inasmuch  as  while  admitting  that  the  malady  is  conta- 
gious undei*  the  most  favorable  conditions,  yet  it  does 
not  seem  to  be  more  si)  than  many  common  diseases, 
the  result  of  an  impaired  condi  Jon  of  blood,  which  are 
generally  accepted  as  being  non-cortagious,  and  onh^ 
become  so  through  pe^uliu'ly  favorable  and  strongly 
coiresponding  cii'cumstances.  Certainly  there  is  no- 
thing in  the  history  of  the  disease,  or  attaclung  to  it,  to 
cause  the  foreigners  visiting  our  she  res,  to  be  in  the 
slightest  degree  a})prehen.'.ive  of  danger.'-  I  think  it 
can  be  asserted  without  fear  of  conti-adi:'tio:i  that  there 
has  not  been  a  single  case  of  leprosy  among  the  white 
or  foreign  population  that  was  not  connected  with  long 
and  intimate  association  with  those  of  the  native  race 
either  having,  or  predisposed  to,  the  disease.  The  case  of 
Rev.  Father  Damien,  referred  to  in  the  ivports  (  f  Drs. 
Mouritz  and  Arr.i  ig,  is  the  most  int  M-es'.ing  and  valua- 
ble one  in  connection  with  the  question  of  contagion. 
As  far  baclv  as  Dec(  nJxr,  L^'TT,  this  faithful  servant  of 
Chiist  wrote  to  ilis  Excellency  J.  Mott  Smith,  then 
President  of  the  Board  of  Health,  '*!  diall  endeavor  to 
do  all  I  can  for  the  benefit  of  the  Board,  and  also  of  the 
sick  people  here.  '"  ^  -  You  are  aware  t/nd  for  the 
general  welfare  (f  the  lepers  1  have  sucr'jiccd  nifj  henltli  and  all 
I  have  in  the  ivorld,  and  in  consequejice  you  may  trust 
me." 

To  those  rx-quainted  with  the  strictness  and  pur- 
itv  of  life  of  such  men  as  enroll  themselva'S  in  the  ranks 
of  the  Christian  Arn:}^  as  true  soldiers,  and  especially 
the  men  cf  the  8tr.n  j)  aid  mould  of  mind  of  Father 
Damien,  it  is  ni.necc  e^aiy  to  say  th:it  th^  i  Klucements 
to  the  disease,  too  frequently  m  ^"  with  auDi  >-  laym  'ii, 
are  wanting,  and  const  queritly  tlie  t\\\^  c  )nL:igion^  and 
infectious  elements  of  ihe  Uialady  ma/  be  nure  correct- 


38 

ly  analyzed  from  his  ca^^e  than  from  any  othei*.  In  his 
report  the  Eev.  Father  gives  us  hut  a  modest  and  par- 
tial insight  into  the  terribly  trying  life  of  13  years 
among  the  lepers.  Thirteen  years  in  the  elosest  eon- 
tact  with  ''a  distemper  so  noisome,  that  it  might  pass 
for  the  utmost  corruption  of  the  human  body  on  this 
side  of  the  grave.''  Inhaling  fetid  breaths,  cleansing 
the  horrible  ulcers,  watching  over  the  dying  and  hand- 
ling the  semi-putrid  cadavers,  living,  eating,  sleeping 
in  an  atmosphere  polluted  with  disease,  having  his  food 
cooked  by  a  leper,  and  surrounded  by  such  an  aggrega- 
tion of  foulness,  an  escape  from  contracting  the  disease 
would  have  been  regarded  as  miraculous.  I  think  that 
this  case  taken  in  conjunction  with  the  fact  that  the 
foreign  portion  of  the  community  have  been  practically 
free  from  the  disease  is  sufflciently  conclusive  to  enable 
me  to  reiterate  my  belief  that  there  is  no  ground  for 
alarm  for  white  people  from  the  disease.  The  very  val- 
uable tables,  prepared  by  Dr.  Mouritz  and  others, 
which  I  elsewhere  present  to  you,  will  I  think  convince 
you  that  we  may  at  length  hope  that  not  only  has  this 
dread  malady  been  checked  and  to  a  great  extent  con- 
trolled 1)ut  that  it  is  less  virulent  and  malignant  in  char- 
acter. I  think  we  are  justified  in  taking,  in  respect  to 
the  disease,  a  hopeful  view  of  the  future.  Our  duty 
though  must  be  to  closely  watch  the  rising  generation 
while  we  endeavor  to  ameliorate  the  condition  of  the 
sufferers.  In  dealing  with  this  question  let  us,  as  Ha- 
waiians,  remember  that  we  set  an  example  to  the  world 
in  the  spirit  with  which  we  have  treated  the  leper.  The 
unfortunate  has  not  been,  and  should  not  be,  regarded  as 
a  mere  outcast,  as  in  other  countries,  Avhose  life  was  an 
eyesore  and  a  burden  to  the  community,  and  whose 
death  was  desired.  Even  admitting  that  all  attempts  to 
cure  this  dread  disease  which  has  baffled  the  medical  skill 
of  ages  have  failed,  yet  we  should  not  abandon  our 
leprous  brethren  in  despair ;  but  we  should  continue  to 
treat  them  and  to  care  for  them  in  a  spuit  of  love  and 
hope.     Above  all  we  should  try  to  make  the  sufferers 


:^9 

as  coil  ten  t«d  and  comfortable  as  wc  can.  If  wc  cannot 
cure  the  disease  we  can  at  any  rate  alleviate  the  condi- 
tion and  [)ains  of  our  lepers.  I  feel  satisfied  that  in  the 
iin[)roved  condition  of  the  lepers  at  the  branch  hospital 
since  the  Sisters  of  Charity  were  placed  in  charge  may 
be  found,  a  suggestion  upon  Avhich  we  may  act  hi  deal- 
hig  with  the  disease  on  Molokai.  With  a  ])etter  supply 
of  water  now  assured,  the  course  of  treatment  and  the 
line  of  conduct  which  is  apparently  tending  towards 
satisfactory  results  at  Kakaako  might  be  attempted  on 
a  larger  scale  at  the  leper  settlement. 

You  will  notice  by  the  accompanying  reports  that  I 
have  furnished  you  with  all  the  information  I  was  per- 
mitted to  obtain  in  regard  to  this  disease  and  to  its 
treatment  in  this  and  other  countries.  You  will  find 
the  opinions  of  professional  men  frequently  in  conliict, 
but  even  in  this  divei'gence  of  ideas  you  may  find  much 
of  value. 

rRACTICAL  WORK  OR  SCIEXTIFlCi  IXVESTlGATIO.\ . 

After  the  somewhat  costly  experience,  with  practically 
iiiade(j[uate  results,  in  thcv])urely  scientific  investigation 
of  leprosy,  I  feel  inclined,  though  with  some  reluctance, 
to  urge  the  more  practical  method  rather  than  the 
merely  scientific.  No  one  appi'eciates  more  highly  than 
myself  the  interest  and  beauty  of  microscopical  and 
technical  research,  and  more  especially  when  combuied 
with  possible  [)ractical  results  of  vast  importance  to  the 
health  of  the  community,  but  on  the  other  hand  stand- 
ing, with  my  colleagues,  as  a  trustee  of  this  Xation  I 
feel  it  my  duty  to  urge  that  expenditures  for  purely 
scientific  research  shall  not  be  of  the  unknown  and 
never-ending  quantity,  but  in  propoi'tion  to  the  value 
received  by  the  Government  and  people  and  not  merely 
to  the  individual  making  them.  Leprosy  has  so  far 
baffled  science  even  among  nations  who  can  conduct 
their  special  examinations  upon  a  grander  scale  than  we 
can.  yet  there  are  results  from  these  investigations 
of   which  "\vc    may    make   practical    use    with   present, 


40 

if  only  temporary,  profit  and  improvement  to  the  suffer- 
ing patients.  It  should  be  our  aim  therefor  to  devote 
our  actions  and  legislation  in  tiiis  nioi-e  praelical  direc- 
tion. But  we  shall  never  do  vei*y  much  good  as  long- 
as  certain  political  elenic^n^s  regard  this- question  of  lep- 
rosy as  a  political  factor  in  the  coiatrol  of  service  to  the 
counti-y.  It  must  be  regarded  from  a  humanitarian 
and  benevolent,  and  not  tVom  a  political  stand  point. 
The  health  and  welfare  of  the  people  is  our  paramount 
duty  and  I  fe-l  assured  it  will  be  your  greatest  pride  to 
promote.  In  ages  past,  when  Lepers  were  regarded  with 
the  greatest  sternness  and  held  in  the  greatest  dread 
and  abhorrence,  the  nobh^st  examiples  of  public  and  pri- 
vate benevolence  hiive  be  mi  ]3rovi.led  for  us.  In  the 
seventh  centuiy,  merchants  established  in  Jerusalem  the 
Hospital  of  St.  John  where  the  Johannites  attended 
upon  the  sick  lepers,  and  a  'Mittle  later,"  as  Dr.  Live- 
hig  informs  us,  "  the  remarkable  society  of  tliL^  Knights 
of  8t.  Lazarus  was  founded.  i:i  order  that  the  lepers  of 
higher  classes  might  not  be  deprived  of  their  knightly 
honors  and  fame.  These  knights,  were  employed  in 
superintending  the  leper  hospitals  and  providing  for  the 
wants  of  the  inmatco."  And  still  later  on  under  the  in- 
fluence of  reli,:>ious  ordei's,  ''  kind  and  considerate  treat- 
ment forth  3  unfi)i'tunate  lepers  was  strongly  inculcated 
and  consolations  were  frequently  given  ;  by  some  indeed 
they  wei'e  looked  upon  as  miirtyi's,  and  were  treated  with 
far  more  kindness  and  compiision  than  they  now  meet 
with  in  Eastern  or  even  Eur.  ptan  countries." 

The  old  histoi'ian  Matthew  Paris  relates  the  following 
interestino-  story  : — 

"David,  King  of  Scotland,  the  brother  of  JNIatilda, 
Queen  of  the  English,  came  to  England  to  visit  his  sis- 
ter (in  the  year  IlOo),  and  when  on  a  certain  evening 
he  caine  by  inv'itatijn  to  her  chamber,  he  found  the 
house  filled  with  lepers,  and  the  Queen  standing  in  the 
midst;  having  laid  aside  h^r  cloak  she  with  bjth  her 
hands  girded  herself  with  a  towel,  and  water  being 
placed  m  i-eadiuess,  she  begau  to  wash  tlitir  feet  aad 


41 

wipe  them  with  the  towel,  and  taking  their  feet  in  her 
hands,  kissed  them  with  the  ntmost  devotion.  Upon 
which  her  brother  addressed  her  thus :  '  What  is  this 
which  you  are  doing,  my  Lady?  In  truth  if  the  King 
knew  this,  he  would  never  deign  to  kiss  with  his  lips 
your  mouth,  contaminated  by  the  pollution  of  the  lepers' 
feet.'  And  she,  smihng,  replied,  'Who  knows  not  that 
the  feet  of  an  eternal  King  are  to  be  preferred  to  the 
lips  of  an  earthly  one?  Behold,  it  was  for  this  that  I 
uivited  you,  dearest  brother,  that  you  might  learn,  by 
my  example,  to  perform  similar  actions.  Do,  I  be- 
seech, that  which  you  see  me  doing.'  " 

King  Kobert  Bruce  of  Scotland,  who  was  suspected 
of  being  a  leper,  founded  near  the  town  of  Air  a  hospi- 
tal for  lepers.  Then,  too,  let  us  bear  in  mind  that  Christ 
''moved  with  compassion,  put  forth  his  hand,  and 
touched  a  leper,  and  said  unto  him,  '  I  will :  be  thou 
clean,'  "  and  immediately  the  leprosy  departed  from 
the  man  and  he  was  cleansed. 

OPPORTUNITIES  FOR  CHRISTIAN  BENEVOLENCE. 

In  modern  times  true  Christian  benevolence  plays  an 
important  part  in  the  treatment  of  the  lepers.  Out  of 
the  sixteen  leper  asylums  in  the  great  empire  of  British 
India  two  are  wholly  supported  by  private  charity  and 
five  partially  so.  Here,  in  Hawaii,  also,  we  are  not  be- 
hind hand,  for  in  the  noble  devotion  of  the  Sisters  at 
Kakaako,  Father  Damien's  self-sacrifice  at  Molokai, 
the  Queen's  Hospital  and  Kapiolani  Home  we  have  a 
good  nucleus  of  charitable  work  from  which  piivate 
benevolence  may  expand.  In  tending  the  sick,  cloth- 
ing the  poor,  and  cheering  up  the  downhearted,  in  pro- 
viding for  them  little  luxuries  and  making  them  more 
comfortable  and  contented,  is  afield  open  to  all  who  un- 
derstand their  duties  and  have  warm  and  courageous 
hearts.  In  this  field  experience  shows  that  ladies  in- 
spired by  Christian  love  are  more  courageous,  or  moved 
by  a  stronger  faith  than  men,  for  they  do  not  touch  the 
sufferer  with  a  hesitating  finger  btit  in  the  spirit  of  the 
6 


4:^ 

}nost  devoted  Christian  charity,  such  as  animated  a 
Queen  Matilda  of  England,  or  a  Queen  Elizabeth  of 
Hungary,  lay  hands  upon  the  outcasts  to  help  them,  and 
lighten  their  sad  lot  in  life.  The  Sisters  of  Chaiity  at 
Kakaako  have  completely,  with  their  quiet  but  firm 
methods,  revolutionized  the  condition  of  the  lepers 
and  in  a  few  short  months  turned  an  abode  of  despair 
into  almost  a  comfortable  home ;  so  that  in  the  interest 
of  the  sufferers  of  this  nation  I  pray  that  their  noble 
example  may  be  supplemented  ])y  a  sympathizing  co- 
operation from  private  sources. 

Anothei-  matter  that  is  within  the  scope  of  private 
benevolence,  and  a  proposal  in  regard  to  which  I  re- 
cently made  to  a  committee  of  gentlemen — appointed  in 
Dr.  Arning's  interest — in  the  hope  and  desire  that  it 
would  be  accepted,  is  a  more  thorough  study  of  the  dis- 
ease in  the  great  foqi  of  Molokai,  wherein  can  be  found 
every  type  and  condition  of  the  malady.  What  can 
be  accomplished  by  a  willing  and  conscientious 
man  in  a  comparatively  short  time  is  patent  to  all 
who  will  study  the  reports  and  tables  of  Dr.  Mouritz, 
the  most  complete  ever  furnished  to  this  Govern- 
ment. The  trouble  hitherto  experienced  by  the 
Goverinnent  has  j^een  in  obtaining  a  true  resident  phy- 
sician at  the  settlement.  ^AHiile  pi'ofessedl}^  zealous  hi 
the  cause  of  true  science  and  jealous  of  the  claimed 
reputation  of  humanity,  charity  and  love  for  the  suffer- 
ing, attractions  of  the  capital  have  apparently  been 
greater,  among  some  of  these  professors,  than  the  op- 
portunity of  enlightening  the  world  and  benefitting 
mankmd.  The  true  scientific  student,  like  the  Father 
Damien  of  rehgion,  mil  go  Avhere  he  can  learn  the 
most  and  do  the  most  good,  and  I  feel  assured  that  this 
honorable  body  will  iiever  be  averse  to  assisting  private 
benevolence  in  encouraging  such  men.  Such  men  take 
their  chances  of  loss  of  friends,  and  somet'nnes  even  of 
loss  of  health  and  life,  but  their  fame  and  the  beneficial 
results  they  liequeath  to  humanity  are  substantial  re- 
wards enough  for  them.     The  country  wants  for  it^s 


43 

suffering  lepers  more  noble  men  and  women  to  attend 
to  their  needs,  nurse  and  help  them.  It  wants  a  cordial 
and  charitable  co-operation  between  people  and  Govern- 
ment. Their  gracious  Majesties  and  other  members  of 
the  v&ya\  family  have  furnished  bright  examples  of  their 
love  for  these  poor  people  and  I  trust  there  are  many 
to  be  found  to  support  them  b}^  good  deeds.  The  sym- 
pathetic human  heart,  moving  a  soft  and  gentle  hand, 
and  a  kindly  eye  ever  bright  and  ready  to  cheer  will  go 
farther  in  the  treatment  of  our  decaying  people  than 
subtle  scientific  investigations  carried  on  in  a  spirit  of 
self-heartedness.  The  Hawaiian  race  is  mentally  de- 
])ressed  as  well  as  physically  ill  and  it  is  encouragement 
to  the  mind  and  heart  that  is  required.  It  must  be 
aided  in  the  spirit  of  the  Divine  love  which  actuates  the 
Sisters  of  Charity  and  their  associates  in  charity  all  over 
the  world,  and  not  in  the  stern  scientific  methods  of 
Faculties,  whether  of  London,  Paris,  Berlin,  ^NTew 
York  or  elsewhere.  Hope  and  confidence  must  be  in- 
spired into  the  drooping  hearts  of  our  suffering  people, 
and  they  must  be  nursed  with  \o\e  and  kindly  advice, 
as  well  as  administered  to  scientifically  or  experiment- 
ally. 

THE    .JAPANESE    HOSPITAL    TREATMENT. 

In  my  general  Health  Report  to  the  Legislature,  I 
have  called  attention  to  the  recent  improvements  made 
at  the  Branch  Hospital,  at  Kakaako,  in  connection 
with  the  system  of  treatment  adopted  by  Dr.  M.  Goto, 
but  I  deem  it  necessary,  also,  to  refer  to  the  subject 
here,  as  being  one  of  more  than  ordinar}^  interest. 

Dr.  M.  Goto,  after  some  experience  with  his  father, 
Dr.  Shobun  Goto,  of  the  Kihai  Hospital,  Tokio,  Japan, 
in  the  treatment  of  leprosy,  was  invited  to  come  to  this 
country  to  give  a  fair  trial  to  the  Japanese  hospital 
method  of  cure.  This  method  had  particularly  at- 
tracted the  notice  of  His  Majesty  the  King  during  his 
visit  to  the  Japanese  Empire,  and,  through  His  Majes- 
ty's love  for  his  suffering  subjects,  resulted  in  the  invi- 
tation to  Dr.  M.  Goto  to  paiy  his  Kingdom  a  visit. 


44 

This  treatment  had  ah-eady  been  satisfactorily  tested 
by  a  gentleman,  declared  by  medical  men  to  be 
afflicted  mth  leprosy,  but  who  after  a  twelve  month's 
stay  at  the  Kihai  Hospital  as  a  patient,  returned  to  this 
country  in  perfect  health.  The  method  may,  in  biief , 
be  stated  to  be  medicated  Avarm  baths  accompanied 
with  regular  therapeutic  and  dietetic  treatment,  the  de- 
tails of  which  will  be  found  to  some  extent  in  Dr. 
Goto's  own  report. 

That  the  Doctor  has,  so  far,  met  Avith  marked  suc- 
cess with  the  patients  at  Kakaako  placed  in  his  care  is 
indisputable.  I  am  enabled  to  state,  from  my  OAvn  ob- 
servation, that  men  and  Avomen,  Avho  were  placed  in  his 
hands,  AAath  dead  looking  and  badly  marked  skins, 
numbed  and  incapable  of  performing  a  healthy  perspira- 
tory function,  have  been  restored  to  normal  healthmess 
and  action,  accompanied  Avith  a  ncAV  groAA^th  of  hair 
upon  parts  formerly  affected,  Avith  the  texture  of  the 
skin  made  soft  and  smooth,  eyes  bright  and  clear,  a 
lively  sensibility  promoted  in  the  former  numb  parts 
and  general  health  correspondingly  improved.  Foul 
ulcers  have  been  cleansed  and  closed  and  helpless 
ati^ophied  members  again  made  actiA^e.  After  former 
experience  in  this  direction  of  curative  or  palKative 
measures,  I  do  not  desire  to  speak  too  sanguinely,  but 
it  is,  undoubtedly,  the  unanimous  opinion  of  all  those 
most  interested — the  patients  themselves — that  Dr. 
Goto's  treatment  has  been  attended  AA^th  an  apparent 
marked  success  ncA^er  before  obserA^ed  on  these  Islands. 
There  is  evidently  nothing  occult  or  mysterious  about 
the  treatment,  which  is  simply  a  combination  of  clean- 
liness, comfort,  good  nourishing  food,  and  medical 
treatment  with  drugs,  tonics  and  barks  Avell  knoAvn,  but 
perhaps  not  sufficiently  iuA^estigated  and  tested  as  to 
their  merits,  by  the  average  medical  practitioners.  Per- 
haps in  the  stimulative  bark  of  the  (Escidus  Turlinata^ 
knoAvn  to  the  Japanese  as  Hichyo  and  Tochi,  there  may 
be  greater  virtues  than  in  any  medicine  hitherto  used. 
It  is  no  longer  a  professional  secret,  as  a  leading  medical 


45 

journal  tells  us,  that,  many  of  the  most  valuable  formu- 
las of  the  modern  Materia  Medica  are  derived  from  ' '  old 
women's  remedies,"  and  others  from,  onee-ealled,  em- 
pirical nostrums.  But,  in  no  case  should  the  successful 
result  be  attributed  to  medicine  alone,  for  whatevei* 
may  oe  the  virtues  of  the  remedies  used,  it  is  to  the 
kindly  and  attentive  physician,  and  the  patient,  watch- 
ful nurse  that  the  true  credit  of  healing  mainly  belongs. 

The  medicinal  \drtues  of  Dr.  Goto's  treatment  are 
aided  b}'  his  faithful  and  assiduous  attention  to  the  re- 
quirements of  his  patients.  He  is  fortunate,  too,  in 
having  to  assist  him  the  Sisters  of  the  Hospital  who 
carry  out  the  physician's  instructions  with  unremittmg 
care  and  a  kind  attention.  It  is  only  a  reasonable  pre- 
sumption that,  under  such  circumstances,  a  system  of 
treatment  so  patiently  and  thoroughly  adhered  to  must 
result  beneficially  to  the  sick. 

Is  it  not  worth  while  even  if  we  do  not,  for  the 
present,  dare  to  hope  for  an  absolute  cure — to  strive  to 
do  as  much  as  we  can  for  our  suffering  countrymen ; 
to  restore  the  apparent  bloom  of  health  to  the  cheek ; 
to  brighten  the  eyes  ;  to  release  the  contracted  muscles  ; 
to  give  back  life  and  sensibility  to  the  numbed  flesh  and 
limbs  and  enable  the  patient  to  feel  more  cheerful  and 
hopeful?  I  am  sure  this  Honorable  Body  will  agree 
with  me  that  it  is,  and,  furthermore,  that,  in  spite  of 
the  opposition  of  those  who  disagree  with  this  special 
treatment,  the  success  of  Dr.  Goto,  so  far,  has  raised 
m  us  the  highest  hope  of  greater  beneficial  results  for 
our  suffering  people.  But  the  result  is  only  made  pos- 
sible by  having  faithful  nurses  to  carry  out  the  method 
of  treatment. 

THE    QUESTION   OF    SEaREGATION. 

This  is  a  measure  fraught  with  the  deepest  interest 
to  a  very  large  portion  of  the  Hawaiian  people.  It  is  a 
question  involving  loss  of  liberty  and  separation  from 
home  and  friends,  to  hundreds,  nay,  thousands,  who  have 
committed  no  offense  against  the  laws  of  the  country. 

/ 


46 

While  recognizing  the  contagiousness  of  this  dread 
malady  under  certain  favorable  conditions,  and  the 
fact  that  its  first  indications  are  hardly  recognizable 
to  the  most  observant  eye,  there  can,  I  think,  be  no 
question  that  it  is  not  contagious  under  casual  circum- 
stances. 'No  contagion  can  arise  from  passing  a  leper 
on  the  street,  sitting  in  the  same  room  with  hhn 
occasionally,  or  shaking  hands,  except,  perhaps,  that  a 
In-oken  skin  might  afford  an  opportunity^  for  doubtful 
inoculation: — doubtful,  as  it  has  not  yet  been  satisfac- 
torily decided  that  the  disease  is  inpculable.  I  feel  in- 
clmed  to  believe  that  greater  danger  ma}^  arise 
from  inhalation  than  fi'om  inoculation,  and  in  this 
view  I  think  I  am  sustained  by  some  of  the  leading- 
medical  minds.  But  it  is  always  wise  to  separate 
the  diseased  from  the  healthy  and,  especially,  to 
break  up  that  too  close  intimacy, — whether  of  family 
or  otherwise, — which  unfortunately,  througTi  want 
of  knowledge  on  the  part  of  Hawaiians,  too  often 
exists  between  the  sick  and  the  healthy.  Hawaii- 
ans certainly  are  beginning  to  appreciate  more  and 
more  the  fact  that  it  is  wise  that  well  developed 
cases  of  leprosy  should  not  live  with  the  clean  and 
healthy,  but  they  also  feel,  as  I  do,  that  the  practice  of 
herding  all  the  sick  in  one  place  of  exile  is  a  hardship 
with  doubtful  results.  If  segregation  can  be  car- 
ried out  in  ways,  equally  beneficial,  but,  more  in  har- 
mony with  the  wishes  of  the  people  it  should  be  done. 
While  it  is  well  for  the  community  that  a  sufferer  from 
any  form  of  contagious  disease  should  leave  his  home, 
it  is  hardly  necessary  to  compel  him  to  leave  his  native 
island.  There  would  seem  to  be  no  valid  reason  why 
an  experiment  of  local  segregation  should  not  be  made 
in  this  regard  on  Kauai,  as  has  been  proposed,  where  a 
retreat  has  been  selected  and  where  families  having  a 
diseased  member  might  there  place  their  suffering  i-elative 
and  attend  to  his  wants,  and  be  nearer  -to  him  than  if 
doomed  to  Molokai.  The  Government  would  be  willing 
to  provide  any  reasonable  measures  of  relief  as  well  as 


47 

to  furnish  medicines.  Wiiere  a  comminiity  is  found 
willing  to  voluntarily  segregate  its  own  sick  and  care 
for  them,  why  should  a  government  be  called  upon  to 
expend  large  sums  for  a  plan  of  segregation  which  can 
never  be  thoi'oughly  carried  out,  bearing  in  mind  the 
occult  and  mysterious  nature  of  the  disease  in  its  long 
term  of  incubation   and  development? 

And  now  in  conclusion  I  beg  to  say  that  while  I  have 
endeavored  to  place  clearly  before  you  the  very  valua- 
ble information  I  have  received,  on  behalf  of  His  Majes- 
ty's Government,  from  foreign  authorities  on  the  sub- 
ject of  leprosy,  I  have  endeavored  to  reciprocate  on  be- 
half of  His  Majesty  the  courtesies  of  other  nations, 
to  whom  the  Kingdom  must,  I  am  sure,  feel  grate- 
ful, by  showing  them  the  work  that  has  been  done 
in  the  past,  and  is  now  being  done  here.  I  am  very 
well  satisfied  that  where  public  spirit  and  benevolence  has 
accomplished  so  much  in  our  country,  we  shall  not 
stand  still  but  march  on  with  redoubled  effort,  and  with 
a  hope  and  a  trust  that  it  may  be  Haw^aii's  glory  to 
achieve  such  a  control  of  this- dread  malady,  the  curse 
of  all  ages,  that  her  name  shall  be  honored  among  the 
nations,  as  a  conqueror  under  the  leadership  of  Love 
for  all,  Charity  for  the  sick,  and  Hospitality  to  the 
stranger,  the  three  great  Marshals  of  the  Grand  Army 
of  Peace. 

GOD  SAVE  THE  Ki:>f  G ! 

WALTEE  M.  GIBSON, 

President  of  the  Board  of  Health. 


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